research on domestic violence in india

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• Published: 22 June 2024

Prevalence of intimate partner violence among Indian women and their determinants: a cross-sectional study from national family health survey – 5

• Sayantani Manna   ORCID: orcid.org/0000-0001-9093-1172 1   na1 ,
• Damini Singh   ORCID: orcid.org/0000-0002-3574-4398 1   na1 ,
• Manish Barik   ORCID: orcid.org/0000-0001-7582-1047 1 ,
• Tanveer Rehman   ORCID: orcid.org/0000-0003-2377-4394 1 ,
• Shishirendu Ghosal   ORCID: orcid.org/0000-0003-1833-3703 1 ,
• Srikanta Kanungo   ORCID: orcid.org/0000-0001-5647-0122 1 &
• Sanghamitra Pati   ORCID: orcid.org/0000-0002-7717-5592 1  

BMC Women's Health volume  24 , Article number:  363 ( 2024 ) Cite this article

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Introduction

Intimate partner violence (IPV) can be described as a violation of human rights that results from gender inequality. It has arisen as a contemporary issue in societies from both developing and industrialized countries and an impediment to long-term development. This study evaluates the prevalence of IPV and its variants among the empowerment status of women and identify the associated sociodemographic parameters, linked to IPV.

This study is based on data from the National Family Health Survey (NFHS) of India, 2019-21 a nationwide survey that provides scientific data on health and family welfare. Prevalence of IPV were estimated among variouss social and demographic strata. Pearson chi-square test was used to estimate the strength of association between each possible covariate and IPV. Significantly associated covariates (from univariate logistic regression) were further analyzed through separate bivariate logistic models for each of the components of IPV, viz-a-viz sexual, emotional, physical and severe violence of the partners.

The prevalence of IPV among empowered women was found to be 26.21%. Among those who had experienced IPV, two-thirds (60%) were faced the physical violence. When compared to highly empowered women, less empowered women were 74% more likely to face emotional abuse. Alcohol consumption by a partner was established to be attributing immensely for any kind of violence, including sexual violence [AOR: 3.28 (2.83–3.81)].

Conclusions

Our research found that less empowered women experience all forms of IPV compared to more empowered women. More efforts should to taken by government and other stakeholders to promote women empowerment by improving education, autonomy and decision-making ability.

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Domestic violence is one of the emerging problems in recent years in both low- and middle-income as well as high-income countries. Gender-based violence, another leading public health problem identified in 1996, is a matter of human rights rooted in gender inequality [ 1 ]. The Sustainable Development Goals (SDG) from 2015, also recognized the importance of gender-based violence, which is an advance step to eliminate gender inequality and women empowerment [ 2 , 3 ]. Intimate partner violence (IPV) is recognized as the most common gender-based violence, which is mostly used as synonymously as domestic or spousal violence but conceptually a subtle difference is present [ 4 ]. IPV affect general health and reproductive health of women, causing chronic pain, injuries, fractures, disabilities, unwanted pregnancy and over expose to contraceptive pills, increasing vulnerability to sexually transmitted diseases [ 5 ]. Such physical and mental strains gradually bring about in the form of post-traumatic stress disorder (PTSD), anxiety, phobia, depression, alcohol abuse etc [ 6 ].

IPV has become a global public health problem with the consequences of premature deaths and injuries [ 7 ]. World Health Organization (WHO) has recognized IPV as a “global hidden epidemic” [ 8 , 9 ]. Worldwide, one-third of the women have experienced IPV [ 3 ]. Due to stigma and fear Intimate Partner violence (IPV) on married women remain unreported in India [ 10 ]. IPV has been recognized as a criminal offence under Indian Penal Code 498-A since 1983. Victims are offered civil protection under the Protection of Women from Domestic Violence Act (PWDVA) 2005, which covers all forms of physical, mental, verbal, sexual and economic violence (unlawful dowry demands), including marital rape and harassment etc [ 11 , 12 , 13 ]. According to the National Crime Record Bureau’s report, the rate of total crime per lakh ( per lakh defined in the Indian numbering system as equal to one hundred thousand) in the women population is 56.5 [ 14 ].

Evidence suggests IPV is associated with low socioeconomic status and unemployment. Indian-employed women faced IPV at a lower rate [ 15 ], while other researchers have identified it as an increased risk of violence [ 16 ]. Other studies illustrated little consistency between women empowerment and violence across varying cultures, where educational attainment, income, decision-making, and contextual factors all play vital roles individually [ 17 , 18 , 19 ]. On the contrary empowered women and following economic independence act as a shield to domestic violence in high-income countries [ 20 ]. Consequently, women’s empowerment would continue to be perceived as a “zero-sum” game with politically robust beneficiaries and weak losers if it was advocated as a goal in and off itself [ 22 ]. There may be present specific association and management techniques for each sort of IPV which must thus be researched independently [ 15 ]. Hence, in this study, we estimated the prevalence of different IPV categories against empowerment status of women and determined the sociodemographic behaviour associated with IPV.

Overview of data

India is home for more than 1.4 billion population, making this country the second-most populous country in the world [ 23 ]. The National Family Health Survey-5 (NFHS-5), which was conducted in all 28 states and 8 union territories of the country, is representative at the national and state/UT levels, adopted in each survey round. A two-stage sampling was done to choose villages and census enumeration blocks from districts in rural and urban regions, respectively. From June 2019 to April 2021, data were collected using CAPI. (Computer-Assisted Personal Interview) with an internal scheduling and adequate maintenance of respondent anonymity. The NFHS-5 methodology has been extensively explained and published elsewhere, including the methods for choosing households and data collection [ 24 ].

Study population and study design

The design for this research is comparable to a cross-sectional study because the secondary data used here is collected during the two phases of NFHS-5: from June 17, 2019, to January 30, 2020, and from January 2, 2020, to April 30, 2021. Women who lived with their spouses or partners and experienced any event of domestic abuse, ever till the day of the interview, were included. The included observations were then the subject of secondary data analysis.

Sample size

Among the 724,115 women interviewed during the NFHS-5, information was acquired from “never-married” or “ever-married” women aged 18–49 years on their experience of violence committed by their present and previous spouses. Only participants who lived with a partner (married or unmarried) were included in this study ( Fig.  1 ) . As a result, 68,949 women formed the ultimate sample size.

Flow diagram of sample selection from the women’s questionnaire of the NFHS-5

Independent variables

The current study focused on the sociodemographic covariates like age, residence (rural/urban), caste, respondent educational qualification, partner’s educational qualification, religion (four categories: Hindu, Muslim, Christian and other religions), wealth index (five quintiles: poorest, poorer, middle, richer and richest quintile), and women empowerment (three categories: low, medium and high ). Another two sets of covariates were the partner’s habit of alcohol consumption and partner controlling behaviour, both dichotomous, grouped as ‘yes’ or ‘no’.

Levels of women’s empowerment were assessed using three indicators: (1) women’s decision-making ability for the household (including access to healthcare, household purchasing and freedom to visit relatives, spending husband earnings, beating wife refuse to have sex), (2) beating indicators(beating the child, wife when argues or refuse to have sex etc.) (3)controlling indicators (includes if allowed to go to market, health facility, outside the village, is justified if went outside without telling), and (4) five economic indicators explaining ownership of the land, house, working status, having a bank account and if owns a mobile phone. All the selected variables are coded into binary variables 0 and 1. Binary variables were included in the composite index to guarantee consistency, while ordinal variables were recoded into binary variables. Table A1 in the supplementary file describes the final variables and their recorded values.

During principal component analysis (PCA), scree plots were examined to determine the number of components to be retained. The scree plot shows that only five components’ eigenvalue is more than 1, which were further processed [ 4 , 19 , 25 ]. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy (greater than 0.04 in the PCA) analysis indicates that the sample sizes in this study were appropriate for PCA (Table A2 in the supplementary file). For all components, Bartlett’s test of sphericity confirms that the selected markers of women’s empowerment were intercorrelated. Furthermore, the reliability coefficient (Cronbach’s alpha score:0.60–0.79) demonstrates an adequate component correlation level. We utilized the first component only after loadings and computing component scores, and the index scores were then divided into quintiles (low, medium, and high). Finally, for each selected nation, an overall index of women’s empowerment was built with three ordered categories: low, medium, and high, where ‘low’ indicated women had lower employment and ‘high’ meant women had more empowerment.

Outcome characteristics: intimate partner violence status

In NFHS-5, a series of questions were asked to collect information on violence committed by the partners, including husbands. It also examines four types of violence faced by women: physical, sexual, emotional, and severe. The level of violence was determined by asking all “ever-married” women if their husbands had ever done the following to them:

• Physical violence

The IPVs which include any physical violence inflicted on a woman by her husband/partner, which provides for: (a) ever slapped; (b) arm twisted /hair pulled; (c) pushed, shaken/had something thrown at them; (d) punched with a fist or hit by something harmful; (e) kicked/dragged; (f) strangled /brunt; (g) threatened with any weapon.

• Sexual violence

The Sexual IPVs were captured by three questions in the dataset: (a) physically forced to have sexual intercourse; (b) physically forced to perform any other sexual acts (c) forced you with threats / in any other way to perform sexual acts.

Emotional violence

Emotional violence recorded by these questions (a) ever having been said /done something to humiliate you in front of others, b) threatened to hurt /harm you or someone close to you, c) insulted you/make you feel bad about yourself.

Severe violence

Severe violence includes physical acts like beatings, choking, burning, and using weapons, as well as sexual violence [ 5 , 26 ]. NFHS-5 asks specific questions to gather this information are a) ever bruises, b) eye injuries, sprains, dislocations or burns, c) severe burns, d) wounds, broken bones, broken teeth or others.

The answer was classified as “never” if the response was “frequently”, “occasionally”, or “yes but not in the previous 12 months”. Except for ‘never,’ all responses to questions on IPVs indicated prior exposure to physical, sexual, emotional, or serious violence. For simplicity, all responses except ‘never’ were coded as Yes = 1 but never as No = 0.

Statistical analysis

Data analysis was conducted in STATA v17.0 (Stata Corp., Texas). The Fig.  2 below presents a conceptual framework for predicting the socioeconomic determinants of IPV in India. Using this framework, IPV can be characterized as a function of the individual, household, and community variables (Fig.  2 ) . We also analyzed weighted profiles of various IPVs among the sociodemographic and expressed them in numbers and proportions. Distribution of the number of IPV among other categorical was presented as frequencies and association in p-value (< 0.002). To account for the complex survey design, we utilized the domestic violence weighting variable (d005) provided in the NFHS data and applied the survey command (svy), which enabled us to weight the data accurately.

For each independent variable, we performed univariate analysis (Table A3 ) and incorporated the variables with significant p-values to the multivariable logistic regression model. To assess the appropriateness of the model fit, we utilized two statistical tests: the AIC BIC test and the Hosmer-Lemeshow test. The diminishing values of AIC and BIC suggest that the model is well-suited for the analysis. Moreover, the Hosmer-Lemeshow test yielded a p-value of > 0.05, which reinforces our conclusion that the model is a suitable fit for this analysis. These preliminary models aimed to establish whether any factors should not be regarded as potential covariates for IPV in the multivariate analysis.

Conceptual framework for the determinants of intimate partner violence

Among the 68,949 women in the study, 26.21% (18,074) experienced intimate partner abuse. Most of them belonged to > 35 years of age (40%), and 46% of women completed secondary-level education [Table A3 (Supplementary file)]. Among 26.21% of women who faced any kind of violence, 60% (11,679) experienced physical violence, 23.87% (4,314) were physically injured due to severe IPV, 2.15% experienced sexual violence, and 9.54% experienced emotional violence (Fig.  3 ).

Distribution of various form of IPV among Indian women

Table  1 shows the sociodemographic profile, which is further classified by the type of violence experienced. A prevalence of 28.39%, among women aged > 35 years was observed for IPV from their partner. In rural areas have the higher incidence of physical IPV at 26%, compared to urban areas. Women belongs to SC caste had the experienced the highest prevalence of IPV. Women with no formal education (39.03%) and less empowered (37.81%) were the most vulnerable to violence. Similarly, 35% of women who didn’t have any formal education had experienced physical abuse by their partner. When the partner is highly educated, IPV was 19% compared to no formal education (41.60%). IPV was almost equally prevalent among Hinduism (27%) and Muslim women (25%) [physical violence (Hindu: 24.40%; Muslim: 21.31%); emotional violence (Hindu: 11.61%; Muslim: 10.94%)]. In the southern region of India, 30% of women have reported experiencing violence.

The distribution of sampled women based on their background characteristics has been presented in Table A4 . The chi-square test is used to assess the strength of association between each socioeconomic variable, and the p-values are provided in the last column of Table A4 . Multivariate regression (Table  2 ) showed a higher chance of experiencing severe IPV among the 25–35 years age-group than the 35–49 years age group with AOR 2.18 (95%CI: 1.69–2.80) in comparison with 15–24 years age group. Respondents who didn’t have any formal education had higher likelihood [AOR = 1.65 (95% CI = 1.35–2.02)] of facing physical violence than women having more than secondary education. Partners with no formal education were significantly associated with any form of violence compared to the highly educated partners. There was 52% greater likelihood among the less empowered women of facing more emotional violence than the highly empowered women. Less empowered women had a significant odd of experiencing sexual violence [AOR:1.92(1.59–2.31)] than that highly empowered women. Relatively higher odds of physical violence were evident from southern [AOR: 2.10 (1.82–2.42)] and eastern [AOR: 1.75(1.51–2.02)] regions, however, sexual violence was highly associated with western [AOR: 1.21 (0.92–1.59)] part of India. Partner’s alcohol drinking was found to be an attributing factor for any form of violence, i.e., emotional violence [AOR: 2.34 (2.09–2.63)], physical violence[AOR: 2.76 (2.52–3.03)] sexual violence [AOR: 3.31 (2.83–3.88)] or severe violence [AOR: 3.38 (2.94–3.89)]. Partner controlling behaviour also evolved as a determining factor for any violence, i.e., emotional violence [AOR:6.63(5.87–7.47)], Physical violence [AOR:3.62(3.33–3.94)] and sexual violence [AOR:6.60(5.53–7.88)].

Our analysis showed a statistically significant increase in physical violence, particularly among women who were less empowered. At the individual level, it has been shown that women are less likely to experience IPV when they are more educated, higher income status, and are empowered. Household-level factors demonstrated that they had significance in intimate partner violence as well as the community-level factors showed the same (i.e., husband’s education, controlling behaviour and drinking Alcohol).

The results of this study demonstrate that a few individual factors strongly explain IPV. For instance, young women who belong to a scheduled caste, being from lower income group and with less level educationwere more likely to experience spousal violence. Previous evidence supported that higher prevalence of IPV is observed among women from Schdule Tribe and Schdeduled Caste [ 27 , 28 ]. Being from lower socioeconomic status also found to be elevating the risk of IPV in women. The literature with the similar evidence confirm that the women from marginal poor segment of society [ 29 , 30 , 31 ] .

Significantly, the more alcohol is consumed, the more nuanced the association between the variables of women empowerment become. According to the findings of this study, women who indicate that their husbands frequently or occasionally consume alcohol have a higher likelihood of experiencing all types of IPV than empowered women who report their husbands never consume alcohol [ 33 , 34 ].

Working women with higher education, on the other hand, experienced higher IPV exposures as compared to their non-working counterparts. The ego considerations of the spouses and gender prejudices in Indian society are likely reasons for any kind of violence [ 35 , 36 , 37 ]. This public health challenge can be addressed by enhancing economic empowerment there by could providing women the awareness and a platform for protest. Given that different levels of social ecology influence spousal violence, interventions at a higher level may be more effective in challenging spousal violence social norms rather than focusing on individual factors, which are difficult to change at the population level and may take decades or generations to be effective.

Strength & limitation

This study used nationally representative data to understand the prevalence of intimate partner violence. It creates an aggregated index of women’s empowerment, providing a more comprehensive view of its relationship with IPV. The NFHS collects a large data set from a representative sample of the country and hence gives a good estimate of marital violence and its relationships with explanatory factors at the population level. However, one of the key drawbacks was its dependence on women’s self-reporting of partner violence. Spousal violence is delicate and intimate in nature, and it is difficult for women to divulge during major survey data collecting due to recall bias and fear of stigmatisation. Further, we were unable to validate the direction of causation and the causative mechanism of domestic and Intimate Partner violence in India using this cross-sectional data. In addition, our composite measure of women’s empowerment index was not strong by conventional statistical standards.

Finally, the implications of the findings are constrained because the data supplied only allowed for the examination of heterosexual relationships [ 39 ]. It should be emphasized, however, that monogamous heterosexual partnerships are the norm in India, signifying a larger reach in terms of generalizability.

Implication

This study has numerous significant policy consequences. This study provides recent evidence for understanding the underlying factors of IPV in India, where wife-beating is high, women’s decision-making power is limited, and male-dominated cultures prevail across the country, though to varying degrees from rigid gender norms. Women’s empowerment, which in turn could ease the risk of IPV and domestic violence, may be enhanced by economic interventions such as conditional cash transfers gender sensitization workshops, media, and cultural campaigns and microcredit programs [ 40 ].

The findings of this study highlight the need to enhance girls’ education, increasing women empowerment, equity in society by eliminating harmful socio-cultural practises. Nevertheless, sole reliance on economic empowerment falls short in ensuring the comprehensive protection of women. Interventions aimed at empowering women must engage with couples as units and operate at the community level, addressing issues of equal job opportunities and gender-specific roles to be effective.

Data availability

The dataset generated during and/or analyzed during the current study is available from the Demographic and Health Surveys (DHS) repository (with proper permission), Available at: https://www.dhsprogram.com/data/dataset/India_Standard-DHS_2020.cfm?flag=0 .

Abbreviations

National family health survey

Ministry of health and family welfare

Union territory

• Intimate partner violence

Sustainable development goals

Principal component analysis

Adjusted odds ratio

Confidence interval

World health organization

Post-traumatic stress disorder

Demographic health survey

Computer-assisted personal interview

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Acknowledgements

We sincerely thank Demographic and Health Surveys (DHS) and the Ministry of Health and Family Welfare (MoHFW) for providing the NFHS-5 dataset.

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Sayantani Manna and Damini Singh contributed equally to this work.

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Division of Health Research, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India

Sayantani Manna, Damini Singh, Manish Barik, Tanveer Rehman, Shishirendu Ghosal, Srikanta Kanungo & Sanghamitra Pati

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TR, SK and SP conceived the study. TR and SK developed the analytical framework. SM, DS and MB performed the analysis, produced results and drafted manuscript. SK, TR and SG monitored the analysis. All Authors edited the manuscript. SP provided overall guidance and supervised the study.

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Correspondence to Srikanta Kanungo or Sanghamitra Pati .

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Manna, S., Singh, D., Barik, M. et al. Prevalence of intimate partner violence among Indian women and their determinants: a cross-sectional study from national family health survey – 5. BMC Women's Health 24 , 363 (2024). https://doi.org/10.1186/s12905-024-03204-x

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DOI : https://doi.org/10.1186/s12905-024-03204-x

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Burden, trend and determinants of various forms of domestic violence among reproductive age-group women in India: findings from nationally representative surveys

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Premkumar Ramasubramani, Yuvaraj Krishnamoorthy, Karthiga Vijayakumar, Rajan Rushender, Burden, trend and determinants of various forms of domestic violence among reproductive age-group women in India: findings from nationally representative surveys, Journal of Public Health , Volume 46, Issue 1, March 2024, Pages e1–e14, https://doi.org/10.1093/pubmed/fdad178

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Violence, a notable human rights concern, has a public health impact across the globe. The study aimed to determine the prevalence and determinants of domestic violence among ever-married women aged 18–49 years in India.

Secondary data analysis with National Family Health Survey 5, 2019–21 data (NFHS-5) was conducted. The complex sampling design of the survey was accounted-for during analysis. The primary outcome was domestic violence. Prevalence was reported with 95% confidence interval (CI). Prevalence ratio was reported to provide the factors associated with domestic violence using Poisson regression.

About 63 796 ever-married women aged 18–49 years covered under domestic violence module of NFHS-5 survey were included. Prevalence of domestic violence (12 months preceding the survey) was 31.9% (95% CI: 30.9–32.9%). Physical violence (28.3%) was the most common form followed by emotional (14.1%) and sexual violence (6.1%). Women with low education, being employed, husband being uneducated or with coercive behavior had significantly higher prevalence of domestic violence.

One-third of the reproductive age-group women were facing some form of domestic violence. Target group interventions like violence awareness campaigns, women supportive services and stringent law enforcement should be implemented to eliminate domestic violence by year 2030.

• domestic violence
• reproductive physiological process
• sexual assault
• secondary data analysis

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The Risk Factor of Domestic Violence in India

Meerambika mahapatro, vinay gupta.

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Address for correspondence: Dr. Meerambika Mahapatro, National Institute of Health and Family Welfare, Baba Gang Nath Marg, Munirka, New Delhi - 110 067, India. E-mail: [email protected]

Received 2011 May 20; Accepted 2012 Feb 19.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background:

It is over the last decade that research in this field of domestic violence has led to greater recognition of the issue as public health problem. The paper aims to study the prevalence of physical, psychological, and sexual violence and potential risk factors of the women confronting violence within the home in India.

Materials and Methods:

A multicentric study with analytical cross-sectional design was applied. It covers 18 states in India with 14,507 women respondents. Multistage sampling and probability proportion to size were done.

The result shows that overall 39 per cent of women were abused. Women who have a lower household income, illiterate, belonging to lower caste, and have a partner who drinks/bets, etc. found to be important risk factors and place women in India at a greater risk of experiencing domestic violence.

Conclusion:

As India has already passed a bill against domestic violence, the present results on robustness of the problem will be useful to sensitize the concerned agencies to strictly implement the law. This may lead to more constructive and sustainable response to domestic violence in India for improvement of women health and wellbeing.

Keywords: Domestic violence, education, India, risk factor, zone

Introduction

The ubiquity of domestic violence (DV) can be gauged from the fact that it has been documented in different cultures and societies all over the world. There is growing awareness that DV is a global phenomenon and is a serious issue in developing countries as well.( 1 ) Nevertheless, DV shows particular forms and patterns depending on the local context and recognized as an important public health problem. Despite the range of abuse, it is the most common cause of nonfatal injury to women, who suffer, blame themselves, and choose not to report it. In fact, often rationalize and internalized the abuse by believing that the act was provoked by the women, therefore, justify and accept it as their fate, to continue living with it.( 2 ) The substantial consequence for women's physical, mental, and reproductive health and ultimately the risk of death from DV is also reported to be high, which is committed by a spouse or partner.( 3 – 5 )

The prevalence of DV in India ranges from 6 per cent to 60 per cent,( 6 ) with considerable variation across the states in different settings.( 3 , 7 , 8 ) However, the magnitude, extent, and burden of the problem in the country have not been accounted well, as the reporting to the problem is still inadequate. In India, few community-based microlevel studies( 4 , 9 ) are available, which confine to physical violence but evidence on psychological violence and sexual violence is limited.( 4 ) There is also very limited empirical evidence of its various determinants, outcome, and their relationships.( 10 )

Various studies from South Asian countries on DV have identified a number of associated individual and household level risk factors which shows that certain demographic factors such as age, number of living male children, and living in extended family have an association with DV.( 11 , 12 ) Among the protective factors identified in developing countries are higher socioeconomic status, women's economic independence, quality of marital relationship,( 9 ) and higher levels of education among women.( 13 , 14 ) The risk of spousal violence against women is globally known to be higher among women who are younger, have a lower household income, less educated, belonging to lower caste, nonworking women, partner who drinks/bets, etc.( 4 , 8 ) However, the issue of DV and its underlying social determinants of DV in developing countries remain limited especially in the context of India.

This paper tries to study the prevalence of physical, psychological, and sexual violence and its potential risk factors for women respondents with their background characteristics such as age, religion, caste, education, occupation, and income, and its association. The term DV is used in the article refers to the violence faced by the women from their husband and family members within the marital home. Any form of DV includes physical, psychological, or sexual violence faced by the women.

Materials and Methods

Study design.

It was a multicentre study and the study design was conceived as an analytical cross-sectional study. Both quantitative and qualitative methods were used. A population-based approach was applied to find out the association between DV and reproductive health consequences.

Inclusion criteria were the married women in the age group between 15 and 35 years. Exclusion criteria were unmarried, widow, and separated women.

Sampling frame

The study was carried out in all the six zones of India, i.e., Northern, Southern, Eastern, Western, Central, and North East, to have a wider representation. Based on the prevalence rate from NFHS-2,( 2 ) the states with high, medium, and low prevalence of DV were selected. In total, 18 states were randomly selected. Keeping in view of 70:30 ratio of rural and urban population, the samples were distributed accordingly. Multistage sampling strategy was used to attain the required samples. For rural sample, two districts and two blocks were selected randomly. 124 villages were chosen for women participants randomly. For urban sample, district headquarters were considered and three socioeconomic strata were identified as high-, middle-, and low-income groups. To select the married women from urban and rural areas, a systematic sampling procedure was followed for households.

Sample size

The sample size was calculated based on the available study that the bad obstetric outcome of pregnancy was 8 per cent and it was expected that the risk would be double (OR = 2) with women subjected to abuse or violence. Using WinPepi, a total of 14,405 female samples were considered for the study (Alpha = 0.05 and 1-Beta = 0.80), which included a margin of 10 per cent nonresponse. Probability proportion to size was calculated for each state.

Study instrument

The study involved collecting data through semistructured questionnaire. A multiphase process was used to develop these questionnaires to ensure that it was culturally and linguistically appropriate. The questionnaire was prepared initially in English and translated and back translated to ensure semantic and content validity. The translated questionnaires were further reviewed for linguistic reliability and appropriateness by the field investigator.

Data validation and management

The data entry package (Epi 6) and the tabulation plan were sent to each centre to bring uniformity. After receiving the data from six participating centers, data were merged. The data were cleaned and validated using excels double data entry.

Data analysis

The data analysis were done using Epi Info, transport to SPSS to calculate proportion, OR, and multivariate logistic regression. 95 per cent confidence intervals (CI) and a P value of less than 0.05 were considered as the minimum level of significance. Content analysis was done for the qualitative data like Focus Group Discussion (FGD), in-depth interview, and case study, respectively.

Measurements

The factors associated with DV included for the analysis were individual- and community-level variables. Multivariate analysis using binary logistic regression (forward method) was applied to 14,507 cases. The statistically significant (<0.20) variables observed in the univariate analysis were included for multivariate analysis. For logistic regression, these variables were used as categorical variables, except the age which was taken as continuous variable. The final model got stabilized after undergoing 12 iterations. Overall efficiency of the model was found 87 per cent approximately. The most parsimonious model obtained in the multivariate analysis with 14,507 cases of which 13,951 have been included in the analysis and 556 cases were missing.

Ethical consideration

The study was approved by the Human Research Ethics, ICMR, New Delhi, and reviewed by senior staff for cultural appropriateness. Informed consent was obtained from all participants, participation was entirely voluntary and confidentiality assured.

The study data revealed that DV was very much prevalent irrespective of rural-urban differentials in the country. On the whole, 39 per cent of the women have mentioned about the incidence of one or the other forms of DV in all the six zones. However, overall 37 per cent of the women indicated prevalence of psychological violence, about 14 per cent of physical and sexual violence in their homes, respectively.

Risk factors of DV

The potential risk factors associated with DV reported by the respondents are discussed using multivariate logistic regression analysis [ Table 1 ].

Binary logistic regression: Risk factors of domestic violence

It is evident that women in the age group between 21 to 35 years were significantly at one time risk of facing DV compared to the women belonged to less than 20 years of age. However, there was a slight decline after 30 years and above age group, which was quite expected as women of higher age group were bound to reduce violence with the passage of time by virtue of their position betters with having adult sons in the family.

The data revealed that women belonged to Muslim religion were at more risk of facing any form of DV compared to women belonged to Hindu religion. While women belonged to Christianity and Buddhism were at no risk, depicting the religion being the protective factor.

The analysis reveals that the infliction of physical as well as psychological and sexual violence was most prevalent among lower caste women who were significantly at greater risk of facing any form of DV compared to upper caste groups.

The data reveal from the regression model that illiterate women were two times significantly at risk of DV (OR = 2.112, CI = 1.812–2.461), whereas women who have completed up to 10 years of schooling (OR = 1.703, CI = 1.474–1.968) and graduation or higher education (OR = 1.207, CI = 1.052–1.384) were significantly one time at higher risk for injury from DV, respectively, compared to the women having professional degree. Though violence decreases with increase of education, the magnitude of DV was considerably high among women with higher literacy also.

The occupation of the participant was recorded and the responses were categorized into i) working women, those contributed to the household income in terms of cash may be engaged in small businesses, daily-waged skilled and unskilled laborers, etc., and ii) house wife. Out of the total women working in different sectors, 49 per cent were facing DV compared to the housewives (36 per cent). In contrast, women who contributed financially none (the house wives) than women whose earnings contributed more to covering their household's expenses were significantly (OR = 0.735, CI = 0.669–0.807) less at risk for DV. Across all the zones, prevalence of DV was higher among the working women compared to the homemakers which were quite contrary to the expected norm. Intraoccupational comparison reveals that women working as nonskilled laborer were facing more DV than the working women of other sector.

Family income

The income of the respondents is indicated by the household's net income per month. The income details were collected in Indian Rupees (INR). The association of family income and DV was found to be highly significant. Women fell in the category of monthly income up to Rs. 3000 were at one time risk of DV compared to women in the family income of Rs. 3001-Rs. 5000 and above.

Size of the family

The association of size of the family and DV was found to be highly significant as women belonged to the family size of the 5–7 members and more than 8 members had one time risk of facing DV, respectively, than the women belonging to the smaller family size of 2 and 3–4 family members, respectively.

Type and length of the marriage

The marriage was categorized in three types namely, arranged marriage, love marriage, and mix marriage, which was love marriage settled by elders. The proportion of the women who reported experiencing DV was significantly two times higher among the women with arranged marriage and three times higher among the women with mixed marriage, respectively, than among women with love marriages. The result shows that any form of DV decreased as the space of marital life increased.

Alcohol consumption

It is evident from the regression model that the prevalence of DV was significantly two times more where husband was found alcoholic (OR = 2.556, CI = 2.358–2.771) as compared to women whose husbands were not habitual of alcohol. However, alcoholism might not be the sole cause of DV as DV was also reported in homes where husband was reported nonalcoholic.

Bet and gamble: Gambling was another menace which leads to DV. It was found from the model that women whose husbands were in the habit of betting and gambling were significantly five times higher at risk of DV (OR = 5.869, CI = 4.561–7.553) as compared to those women whose husbands were not having such habits.

In the present study, the prevalence of DV in India was considerably high persisting across all socioeconomic strata existing in all the communities.( 5 , 11 ) Empirical results have suggested that education of women have an association with DV, which reflects a shift in the thinking pattern and burgeoning down the balance of power between husband and wife.( 9 , 15 ) But, the odds of DV were reduced only for women who had achieved higher education, suggesting that modest increases in educational attainment available to the majority of the women in India will not substantially alter their risks. However, data reflect that the victims were not only among illiterate and poor, who were besieged in traditional folklores and customs, it occurs across all social categories and social set-up.( 5 , 10 ) However, results reported that women working and contributing to the household budget were at increased risk of violence. The expectation expressed in the qualitative data that women's participation in economic activity would lead to higher status, security, and as a protective buffer against DV appears less realistic in the light of the quantitative results.( 1 , 3 )

One limitation of the study was that the family income was calculated based on self-reported items produced in the agricultural land. We presume that the women may not report correctly due to stigma and embarrassment. Previous studies suggest that highly normative support for violence against women exists in this setting and therefore may lead to underreporting Stephenson et al . 2006.

Despite the limitations of reporting bias, the findings highlight the complex and often contradictory nature of the relationships among factors at different levels and the ways in which they influence women's risk of suffering DV. In this context of gender inequality and poverty, the practice of patriarchy appears to exacerbate women's risk of DV. These causes reflect deep-rooted gender inequalities that persist across India.( 9 , 14 , 15 ) The findings of the association between the above analyzed factors suggest that there are broader and overarching reasons behind DV, whose implications go beyond individual and psychological situations. This practice of interpersonal violence may lead to affects the health of the women.( 1 , 11 ) Recognition of emerging health issues is needed to address women facing DV within the cultural milieu to improve maternal health and well-being.

The appalling toll will not be eased out until family, government, institutions, and civil society organizations address the issue collectively. These results provide vital information to assess the situation to develop interventions as well as policies and programmes toward preventing violence against the women. As India has already passed a bill against DV, the present results on robustness of the problem will be useful to sensitize the concerned agencies to strictly implement the law.

Source of Support: Nil

Conflict of Interest: None declared.

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Domestic violence in Indian women: lessons from nearly 20 years of surveillance

Affiliations.

• 1 Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Gurugram, Haryana, 122002, India. [email protected].
• 2 Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA. [email protected].
• 3 Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Gurugram, Haryana, 122002, India.
• PMID: 35448988
• PMCID: PMC9023044
• DOI: 10.1186/s12905-022-01703-3

Background: Prevalence of self-reported domestic violence against women in India is high. This paper investigates the national and sub-national trends in domestic violence in India to prioritise prevention activities and to highlight the limitations to data quality for surveillance in India.

Methods: Data were extracted from annual reports of National Crimes Record Bureau (NCRB) under four domestic violence crime-headings-cruelty by husband or his relatives, dowry death, abetment to suicide, and protection of women against domestic violence act. Rate for each crime is reported per 100,000 women aged 15-49 years, for India and its states from 2001 to 2018. Data on persons arrested and legal status of the cases were extracted.

Results: Rate of reported cases of cruelty by husband or relatives in India was 28.3 (95% CI 28.1-28.5) in 2018, an increase of 53% from 2001. State-level variations in this rate ranged from 0.5 (95% CI - 0.05 to 1.5) to 113.7 (95% CI 111.6-115.8) in 2018. Rate of reported dowry deaths and abetment to suicide was 2.0 (95% CI 2.0-2.0) and 1.4 (95% CI 1.4-1.4) in 2018 for India, respectively. Overall, a few states accounted for the temporal variation in these rates, with the reporting stagnant in most states over these years. The NCRB reporting system resulted in underreporting for certain crime-headings. The mean number of people arrested for these crimes had decreased over the period. Only 6.8% of the cases completed trials, with offenders convicted only in 15.5% cases in 2018. The NCRB data are available in heavily tabulated format with limited usage for intervention planning. The non-availability of individual level data in public domain limits exploration of patterns in domestic violence that could better inform policy actions to address domestic violence.

Conclusions: Urgent actions are needed to improve the robustness of NCRB data and the range of information available on domestic violence cases to utilise these data to effectively address domestic violence against women in India.

Keywords: Domestic violence; Dowry; India; Intimate partner; Suicide.

© 2022. The Author(s).

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• Research Support, Non-U.S. Gov't
• Domestic Violence*
• Gender-Based Violence*
• Heart Arrest*
• India / epidemiology

Empowering Women Through Digital Transformation: A Path to Mitigate Intimate Partner Violence in India

• Published: 06 November 2024

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• Anamika Chakraborty   ORCID: orcid.org/0009-0005-0930-7900 1 &
• Suresh Jungari   ORCID: orcid.org/0000-0003-4223-2603 1  

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The World Health Organization (WHO) reports that a staggering one-third of women worldwide face intimate partner violence (IPV). Recent developments in digital transformations, such as the rapid use of mobile phones, internet use, and mobile use for financial transitions, have been evident. Earlier research shows that women’s digital empowerment or access to digital technologies protects them from IPV. However, there is less evidence on how various digital transformations in women’s lives lead to digital empowerment and protection from IPV. The study addresses whether empowering women through digital transformations leads to IPV prevention or reduction. We used National Family Health Survey-5 round data conducted during 2020–21 in a representative sample of India. We have constructed an additive index of digital empowerment using several questions about mobile use. The study results show that women with high digital empowerment reduced the odds of intimate partner violence when controlling socioeconomic variables.

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Domestic violence against women: A hidden and deeply rooted health issue in India

Abantika bhattacharya, shamima yasmin, amiya bhattacharya, baijayanti baur, kishore p madhwani.

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Address for correspondence: Dr. Shamima Yasmin, Department of Community Medicine, Midnapore Medical College, Midnapore – 721 101, West Bengal, India. E-mail: [email protected]

Received 2020 Mar 30; Revised 2020 Apr 25; Accepted 2020 Jul 2; Collection date 2020 Oct.

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Background:

Domestic violence was identified as a major contributor to the global burden of ill health in terms of female morbidity leading to psychological trauma and depression, injuries, sexually transmitted diseases, suicide, and murder.

The study was conducted to find out the prevalence of different types of lifetime domestic violence against women, factors associated with it, and care-seeking behavior.

Settings and Design:

An observational cross-sectional study conducted at a slum of Burdwan district of West Bengal, India.

Methods and Material:

Study was done among 320 ever-married women of 15–49 years of age using a predesigned pretested proforma from March 2019 to December 2019 by face-to-face interview.

Statistical Analysis Used:

Data were compiled and analyzed by EpiInfo 6 and SPSS 20 version.

Results and Conclusions:

The overall prevalence of any form of violence during the lifetime among the study population was 35.63%. Verbal/psychological violence was the most common form of domestic violence (91.23%) followed by physical (82.46%) and sexual violence (64.91%). Slapping and/or beating, kicking, and object throwing were the major forms of physical violence; humiliation (88.46%) was the commonest form of psychological violence and most common form of sexual violence was forced sexual intercourse (51.35%). About 20% of the study population faced violence every day. Older age, lower age at marriage, longer duration of marriage, lower education of husband and wife, lower family income, unemployment of the husband, and alcohol consumption of husband were associated with the occurrence of domestic violence. We have found that the prevalence of domestic violence in this group of population is high. The alarming issue is that approximately one-third of women (32.46%) who faced violence in their lifetime had never sought any help. The findings indicate to develop appropriate and culturally relevant public health interventions to increase awareness.

Keywords: Care-seeking behavior, domestic violence, socioeconomic status, women

Introduction

The Fourth United Nations World Conference on Women 1995 in Beijing stated that violence against women (VAW) is a manifestation of the historically unequal power relations between men and women.[ 1 ] United Nations declaration on the elimination of Violence against Women (VAW), in 1993, defined VAW 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.”[ 2 ]

The WHO Multi-country Study on “Women's Health and Domestic Violence Against Women” indicated that the range of lifetime physical violence by a male, intimate partner, ranged from 13% in Japan to 61% in Peru with most sites falling between 23% and 49%; range of lifetime prevalence of sexual violence by an intimate partner was between 6% (Japan) and 59% (Ethiopia) with most sites falling between 10% and 50%; range of lifetime prevalence of physical or sexual violence, or both, by an intimate partner, was 15% to 71% with most sites ranged from 30% to 60%.[ 3 ] Likewise, regarding current violence acts of physical or sexual violence in the year prior to being interviewed—the range was between 3% and 54%, with most sites falling between 20% and 33%.[ 3 ] Commonly mentioned perpetrators included fathers, other family members, and teachers. The highest levels of sexual violence by nonpartners ranged between 10% and 12% in Peru, Samoa, and Tanzania city to 1% in Bangladesh and Ethiopia.[ 3 ]

Only one in four abused women have ever sought help to end the violence they have experienced. Only two percent of abused women have sought help from police.[ 4 ]

Domestic violence is an underreported phenomenon in India including West Bengal, although West Bengal stands in the 8 th position according to the burden of domestic violence among all Indian states.[ 4 ] A need was, therefore, felt for a community-based study focusing on domestic violence against women (DVAW) to gather data that would improve our understanding of this “sleeping giant.”[ 5 ]

In this background, the present study was conducted with the objective of to find out the prevalence of different types of “lifetime” domestic violence against ever-married women in reproductive age group (15–49 years) in an urban area of a district of West Bengal, to identify the factors associated with it and also to estimate their care-seeking behavior.

Materials and Methods

A cross-sectional, community-based descriptive, and observational epidemiological study was carried out among all ever-married women of 15–49 years of age residing at a slum of Burdwan district of West Bengal, India from March 2019 to December 2019.

Inclusion criteria were all ever-married women of 15–49 years of age, permanent residents of the studied slum, and willing to participate. Exclusion criteria were women below 15 years and above 49 years, mothers-in-law, unmarried, divorced and separated women, widows, noncooperative women who refused to furnish necessary information, women who were seriously physically or mentally ill, and visitors to that locality. Considering the prevalence of domestic violence as 41.8%,[ 4 ] confidence level of 95%, 15% relative precision, and 10% nonresponse rate, the sample size was computed to be 357.

A sampling frame of the above population was prepared with the help of urban health post. Sampling technique was census population. The study tool was a predesigned pretested semistructured interview schedule. The schedule was prepared in the local language (Bengali) with the help of three experts of community medicine. The new tool was validated by three public health specialists. The pretesting was done among the married women of the adjacent slum area and the women were not included in the sampling frame and minor modifications were done in the tool. Then, the final tool was applied in data collection. Study variables were age in years, age at marriage, duration of marriage, religion, literacy status of study population, husband's education, occupation of study population, employment status of the husband, socioeconomic status (as per Modified Kuppuswamy's Scale 2019),[ 6 ] prevalence, type and frequency of domestic violence, addiction of husbands to alcohol, and their care-seeking behavior.

Procedure for data collection

Home visits were carried out, and face-to-face interview with these women was done in the absence of their guardian/husband by Principal Investigator (PI) and/or Co PIs. The purpose of the study was explained to the participants, informed consent was obtained, and initial rapport was built with the help of female Community Leader. They were also assured that anonymity and strict confidentiality would be maintained. In case the sampled woman was not at home at the time of visit, the next visit was scheduled after prior appointment. Information was gathered about the sociodemographic profile of the participants and whether they were subjected to any domestic violence or not.

The interview lasted for 30–45 min depending on the women's experiences. The reference period considered was any time preceding the survey.

Ethical permission was obtained from the Institutional Review Board of Burdwan Medical College, West Bengal, India.

Data were compiled and analyzed by Epi Info 6 version and SPSS 20 version. Proportions and Chi-square tests were used for analysis of data.

The present study was conducted among ever-married women of reproductive age group (15–49 years) in an urban area of Burdwan District. Out of 357 women, 320 participated while 27 (10.36%) refused because of feelings of shame and fear; thus, the response rate was 89.64%.

Mean age of the participants was 28 ± 5.34 years and majority of the women were in the age group of 25–35 years (33.94%). All were Hindu and were currently in monogamous relationship during the time frame of preceding 12 months of the study. Regarding educational status, 151 (47.19%) were illiterate, and only 4.68% had studied up to higher secondary and above. Majority (92.31%) of the respondents were homemakers and rest 7.69% were unskilled laborers. With regard to socioeconomic status (according to modified Kuppuswamy's Classification 2019),[ 6 ] a majority of the participants (36.56%) belonged to the lower middle class. So far as the occupation of husband was concerned, 277 (86.56%) were employed; 36.54% were unskilled laborers, 33.07% were skilled laborers, 4.61% were doing service, and 13.47% were self- employed. About 60.94% of the husbands of the study population were addicted to alcohol. A considerable number of husbands of participants 102 (31.88%) were illiterate and only 15 (4.69%) passed higher secondary and above. Majority 198 (61.88%) of the study population married after 18 years of age and 86 (26.88%) had married life for more than 10 years.

The overall prevalence of any form of violence during the lifetime among the study population was found to be 35.63% and husband was the main perpetrator followed by other family members.

Verbal/psychological violence was the most common form of domestic violence (91.23%) followed by physical (82.46%) and sexual violence (64.91%) among the subjects.

Slapping and or beating, kicking, and throwing objects were the major forms of physical violence experienced by these women. Humiliation 92 (88.46%) was the commonest form of psychological violence. Most common sexual violence was the use of physical force to have sexual intercourse (51.35%) [ Table 1 ].

Types of physical, psychological, and sexual violence

*Multiple responses

In response to the frequency of domestic violence, the response of the participants was: every day 23 (20.18%), weekly 25 (21.93%), once in 15 days 29 (25.44%), monthly 21 (18.42%), and occasionally 16 (14.04%) [ Table 2 ].

Frequency of domestic violence

Prevalence of all forms of violence increased along with the age of the respondents. Women aged 25–35 years 99 (47.47%) and 35–45 years 42 (51.85%) reported higher. Prevalence of violence in women aged less than 25 years was 22 (28.21%) and this difference was statistically significant ( P < 0.05) [ Table 3 ].

Sociodemographic characteristics and prevalence of domestic violence

Though no significant difference was found so far as literacy of both partners was concerned, the data revealed that education had an impact on the prevalence of domestic violence. The prevalence of violence decreased as educational levels of women and their husbands increased. Sixty-five women (43.05%) with no education had experienced physical or sexual violence, as compared with two women (26.67%) with 12 or more completed years of education. Similarly the women whose husbands were illiterate 48 (47.06%) faced more violence than women whose husbands had higher secondary and above 3 (20%). Study population with unemployed husbands reported more violence 32 (74.42%) than their counterparts with employed husbands 103 (37.18%) and the difference was statistically significant ( P < 0.05) [ Table 3 ].

It was seen [ Table 3 ] that as the age at marriage of the participants was increased (69.67% for those who married before 18 years), the prevalence of domestic violence decreased (48.48% for those who married at 18 years and more). It was also reported that as the duration of married life increased prevalence of domestic violence decreased; those who married for less than 5 years had experienced higher prevalence (47.69%) of domestic violence than those married for more than 10 years (32.56%) ( P < 0.05). Women whose husbands addicted to alcohol (56.41%) experienced more violence than those without alcoholic husbands (20%), which was again statistically significant ( P < 0.05).

About one-third (32.46%) of women who faced violence in their lifetime had never sought any help. More than 23.68% women sought help from their parents, followed by 20.18% from neighbors and only 9.68% had reported to police [ Table 4 ].

Care-seeking behavior of victims

Prevalence of domestic violence

The present study identified that 35.63% had faced domestic violence in any form or in combination in their lifetime. India's National Family Health Survey-III, carried out in 29 states during 2005-06, found that nation-wide, 37.2% of women experienced violence after marriage.[ 4 ] A similar study conducted in a slum of Kolkata revealed that the prevalence of domestic violence was 54%.[ 7 ] Another study in Delhi showed that the prevalence of psychological, physical, sexual, physical, or sexual violence and any form of violence was very high. Domestic violence against women is inversely associated with their mental health. A multisectoral approach is needed to address this problem.[ 8 ] A study on the same topic done by Sarkar[ 9 ] in rural setting of West Bengal showed that the prevalence of domestic violence was 23.4%. Babu and Kar[ 10 ] reported the prevalence of domestic violence of 56.3% in eastern India; 60.7% in Orissa, 51.8% in West Bengal, and 58.9% in Jharkhand. A study by Jeyaseelan et al .[ 11 ] in India showed 26% spousal physical violence during the lifetime of their marriage. The proportion of women who reported physical violence by their spouse was 26.6% in Goa,[ 12 ] 39% in six zones of India,[ 13 ] a total of 69% among nurses in AIIMS of Delhi,[ 14 ] 42.8% in a colony of Delhi,[ 15 ] and 29.57% in Bangalore.[ 16 ]

Prevalence of different types of domestic violence

In a study conducted in Uttar Pradesh by Koenig et al .,[ 17 ] the prevalence of lifetime physical and sexual violence was found to be 25.1% and 30.1%, respectively, which was found to be higher (71.4% and 57.1%, respectively) in our study. The corresponding figures were 35.5% and 10.0% in NFHS III,[ 4 ] 35.9% and 54.1% in Kolkata,[ 7 ] 52.1% and 52.5% in Orissa, 14.6% and 50.6% in West Bengal, 21.2% and 54.5% in Jharkhand, 16.1% and 52.3% in eastern India,[ 10 ] 43.3% and 30% among nurses in AIIMS,[ 14 ] 14% and 14% in six zones,[ 15 ] 31.6% and 10.5% in Bangalore,[ 16 ] and 84% and 90% in a study on five adjoining states of Andhra Pradesh, Chhattisgarh, Gujarat, Madhya Pradesh, and Maharashtra.[ 18 ]

In the present study, women also suffered from more than one type of violence. This was similar with the findings of other studies[ 4 , 14 , 18 ] where the reported violence was multiple in nature and most of the women were subjected to more than one type of violence.

Different forms of physical, psychological, and sexual violence

The most common form of lifetime physical violence was slapping and/beating (80.85%), kicking (68.09%), object throwing (43.62%), and choking and punching the women (29.79%), which was consistent with the findings of other studies.[ 4 , 8 , 9 , 10 , 12 , 14 , 18 ] According to NFHS III, the most common physical violence was slapping (34%) followed by twisting of arms or pulling of hairs (15.4%), throwing something (14%), kicking (12%), and choking (2%).[ 4 ] Humiliation was the most common form of emotional violence in this study and other studies.[ 4 , 9 , 12 ] The most common form of sexual violence was physically forced her to have sexual intercourse (58.3%).[ 4 , 9 ]

In the present study response to frequency of domestic violence, the response of the participants was: every day 23 (20.18%), weekly 25 (21.93%), once in 15 days 29 (25.44%), monthly 21 (18.42%), and occasionally 16 (14.04%). In a study in five states,[ 18 ] about 16% of women reported that they were facing domestic violence once or twice in a week, or once or twice in a month and the percentage of respondents against whom domestic violence was committed practically every day was 15%; which was similar to the present study. In Singur, the study also found that 9.1% faced violence few times in a week or few times in a month, whereas 81.8% faced it in a year.[ 9 ] In Bangalore study, the frequency of violence was at least once in a week in 34.21% women, once in 15 days in 31.58% women, once in a month in 26.32%, and once in 1–3 months in 7.89% women.[ 16 ]

Relation of domestic violence with sociodemographic variables

Age had a profound association with the prevalence of domestic violence. Prevalence of all forms of violence was increased along with the increasing age of the women in the present study and other studies also[ 4 , 9 , 10 , 12 , 13 , 15 ] but Bangalore study[ 16 ] did not reveal this association where it was observed that as age of the women increased, the prevalence of domestic violence decreased.

Education had impact on the prevalence of domestic violence which was inversely associated with education levels of the women and their husbands and it was corroborative with the findings of some other studies.[ 4 , 9 , 10 , 11 , 12 , 13 , 14 , 18 ] In this study, families with low-income level showed a higher rate of violence and the rate of domestic violence decreased as the socioeconomic level increased; some other studies also supported this finding.[ 4 , 9 , 11 , 12 , 13 ]

Alcohol addiction of the husband was found to be strongly related to the presence of domestic violence in this study and other studies.[ 4 , 7 , 11 , 12 , 13 , 14 , 16 ] NFHS III reported that women whose husbands drink alcohol had significantly higher rates of violence than women whose husbands did not drink at all; emotional violence was three times as high, physical violence was more than two times as high, and sexual violence was four times as high.[ 4 ]

Majority of the victimized women preferred to be silent sufferers. The help-seeking behavior was found in one-third (31.5%) of women who had faced violence in their lifetime. These women had never sought any help, even from their relatives and close friends, and preferred to rely upon their own strategies to deal with the situation. This was corroborative to some other studies where 32.7% and 74.4% did not report the abusive situations in which they were living.[ 12 , 13 ] In urban and rural areas of Haryana, 37% of the married females had ever experienced domestic violence.[ 14 ]

In our study, 23.68% women sought help from their parents, followed by 20.18% from friends/neighbors while only 9.65% had reported to police which represented the tip of the iceberg. Notably few women seek help from any institutional sources such as the police, medical personnel, or social service organizations.[ 4 ] In a study in five states, among the respondents who sought help, 26.3% abused women had approached their parents, 15.6% to relatives, and 57.9% to friends.[ 18 ] Goa study revealed that 31.1% talked to relatives or close friends and only 4.4% took legal help.[ 12 ] In the Bangalore study, nobody informed the police.[ 16 ] The present study and some other studies highlighted the factors which had positive influence for domestic violence like young age at marriage,[ 12 , 16 , 18 ] duration of marriage,[ 4 , 14 ] as well as husband's employment status.[ 14 ]

Factors associated with an increased risk of perpetrating violence include low education, child maltreatment, exposure to violence in the family, use of alcohol, attitudes accepting of violence, and gender inequality.[ 19 ]

Emotional and verbal type of violence is the most common type. Caste, religion, literacy status of study subjects, and occupational status of spouses of study subjects were reported as significant correlates affecting the causation of domestic violence among the subjects.[ 20 ]

The effects of violence on a victim's health are severe. Domestic violence can lead to serious short- and long-term physical, mental, sexual, and reproductive health problems for women and lead to high social and economic costs.[ 21 , 22 ] Domestic violence is associated with mental health problems such as anxiety, post-traumatic stress disorder, and depression. Intimate partner violence in pregnancy also increases the likelihood of unplanned or early pregnancies and sexually transmitted diseases, miscarriage, stillbirth, preterm delivery, and low birth weight babies.[ 21 , 22 ]

Limitations of the Study

The sensitivity and stigma associated with violence, as well as fear of reprisal, may lead to under-reporting of violence. A small sample size has limited the generalizability of the present study. Investigation of the effects of violence on health would provide a clearer picture of short- and long-term suffering of the victims.

The present study found that the overall prevalence of physical, psychological, sexual and any forms of violence among women were 69.63%, 77.04%, and 54.81% respectively. The study revealed the high prevalence of all forms of violence against women in an urban area of Burdwan, India. Older age, lower age at marriage, longer duration of marriage, lower education of husband and wife, lower family income, unemployment of the husband, and alcohol consumption of husband were associated with the occurrence of domestic violence.

Ending violence against women needs to be addressed at various levels. The coordinated efforts of various sectors such as social, legal, educational, medical, etc., are essential to address the various economic and sociocultural factors that foster a culture of violence against women in India by strengthening women's human and economic rights and reducing gender gaps in relation to employment and education.

Ethical approval

Ethical and institutional clearance obtained from the Institutional Review Board of Burdwan Medical College, West Bengal, India 04.02.2019.

Declaration of patient consent

The authors certify that they have obtained all appropriate participant consent forms. In the form, the participants have given their consent for their images and other clinical information to be reported in the journal. The participants understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Conflicts of interest.

There is no conflicts of interest.

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• Published: 09 May 2009

Domestic violence against women in eastern India: a population-based study on prevalence and related issues

• Bontha V Babu 1 , 2 &
• Shantanu K Kar 1  

BMC Public Health volume  9 , Article number:  129 ( 2009 ) Cite this article

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Violence against women is now widely recognised as an important public health problem, owing to its health consequences. Violence against women among many Indian communities on a regularly basis goes unreported. The objective of this study is to report the prevalence and other related issues of various forms of domestic violence against women from the eastern zone of India.

It is a population-based study covering both married women (n = 1718) and men (n = 1715) from three of the four states of Eastern India selected through a systematic multistage sampling strategy. Interviews were conducted using separate pre-piloted structured questionnaires for women (victimization) and men (perpetration). Women were asked whether their husband or any other family members committed violent acts against them. And men were asked whether they had ever perpetrated violent acts against their wives. Three principle domestic violence outcome variables (physical, psychological and sexual violence) were determined by response to a set of questions for each variable. In addition, data on socio-economic characteristics were collected. Descriptive statistics, bi- and multivariate analyses were done.

The overall prevalence of physical, psychological, sexual and any form of violence among women of Eastern India were 16%, 52%, 25% and 56% respectively. These rates reported by men were 22%, 59%, 17% and 59.5% respectively. Men reported higher prevalence of all forms of violence apart from sexual violence. Husbands were mostly responsible for violence in majority of cases and some women reported the involvement of husbands' parents. It is found that various acts of violence were continuing among majority of women who reported violence. Some socio-economic characteristics of women have significant association with the occurrence of domestic violence. Urban residence, older age, lower education and lower family income are associated with occurrence of domestic violence. Multivariate logistic regressions revealed that the physical violence has significant association with state, residence (rural or urban), age and occupation of women, and monthly family income. Similar associations are found for psychological violence (with residence, age, education and occupation of the women and monthly family income) and sexual violence (with residence, age and educational level of women).

The prevalence of domestic violence in Eastern India is relatively high compared to majority of information available from India and confirms that domestic violence is a universal phenomenon. The primary healthcare institutions in India should institutionalise the routine screening and treatment for violence related injuries and trauma. Also, these results provide vital information to assess the situation to develop public health interventions, and to sensitise the concerned agencies to implement the laws related to violence against women.

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Violence against women is widely recognised as an important public health problem, owing to its substantial consequences for women's physical, mental and reproductive health [ 1 – 5 ]. This recognition was strengthened globally by resolutions of various international fora including fourth World Conference on Women in 1995 in Beijing [ 6 ]. In India, the problem has been highlighted after legislation against domestic violence in 2005, popularly known as the Protection of Women from Domestic violence Act [ 7 ]. Research across the world has provided increasing evidence of the problem of violence against women [ 8 , 9 ].

India possessed several communities which are distinct in their geography, language and culture. In several places of India, violence faced by women on a regularly basis goes unreported even in newspapers, where as newspapers often carry reports about young women being burnt alive or dying due to unnatural causes in unnatural circumstances [ 10 ]. Estimates of prevalence of domestic violence within India vary widely (from 18% to 70%, with differences in study methodology) [ 10 – 20 ], and it is realized that the magnitude of the problem has not been accounted well from several parts of India. There are very few studies covering the population across the country [ 14 – 16 , 18 ]. The third national family health survey revealed that there is considerable variation across the states in the prevalence of domestic violence [ 18 ]. A closer scrutiny of the prevalence rates reveals that domestic violence is a country-wide phenomenon with some variations between states, as these states differ from each other in overall socio-economic development and women's status [ 18 , 21 ]. A few community-based micro-studies are available from northern [ 11 , 19 ], southern [ 11 , 17 ] and western states [ 10 ] of India. However, community-based studies are not available from eastern part of India. Also, the available community-based studies are limited to physical violence. The third national family health survey revealed that more than a third of women in India have been physically mistreated by their husbands or other family members [ 18 ]. Some community-based surveys suggested that physical violence has been experienced by 21 to 48% of women in different settings in India [ 10 , 11 , 15 , 20 ]. The above estimates are corroborated by studies investigating reporting patterns of men. And 21 to 40% of men in different studies reported perpetrating physical violence [ 12 , 13 , 19 , 20 ]. Evidence on psychological violence is limited. Available community-based studies suggested that psychological violence ranged from 23% to 72% [ 10 , 11 , 13 , 15 ]. Evidence on sexual violence, as in the case of psychological violence, is also limited. A multi-site study revealed that 15% of sampled women reported one or more incidents of forced sex [ 15 ]. A study carried out in a district in Western India reported that 20% of the women reporting physical violence described abuse of sexual nature [ 10 ]. Studies with men revealed that 9% [ 12 ] to 26% [ 19 ] and 50% [ 13 ] of men reported perpetration of sexual violence. It is worth-noting that majority of the studies from India are based on the investigations on married women. A few studies are based on reporting of men [ 12 , 13 , 19 , 20 ]. In addition to above prevalence studies, there are a few qualitative studies to support the extent of burden of domestic violence in India [ 22 – 24 ].

We hypothesize that domestic violence is wide-spread phenomenon and variation in its prevalence occur across the eastern Indian states, as these states differ from each other in overall development. Also, it is hypothesized that differences occur within the population of these states based on some socio-economic characteristics such as habitation (rural or urban residence), age, religion/caste affiliation, education, occupation and income. The purpose of the present study is to report the prevalence of various forms of domestic violence against women and to examine various related issues from the eastern zone of India. The term domestic violence is usually taken to mean partner abuse, specifically violence perpetrated by male partner. However, it may also be used to refers to violence perpetrated by any member of the household towards the women [ 25 ]. However, this paper deals with the violence faced by women, perpetrated by their husbands and other family members within their conjugal homes.

Study area and participants

The eastern zone of India possessed four states namely, Orissa, West Bengal, Bihar and Jharkhand. Of these four states, three states (Orissa, West Bengal and Jharkhand) were selected to have a wider representation of the zone. The population of these states was 31.7 million, 80.2 million and 26.9 million in the year 2001 [ 26 ]. This study was a cross-sectional study. The participants were both men and women. The study involved collecting quantitative data through structured questionnaires. The questionnaire for women included items on socio-economic details and domestic violence experience. To assess domestic violence exposure, women were asked several questions on various behaviours of violence (see Annexure 1a in Additional file 1 ). Questions were posed to get their experience to a specific act of violence during their life time as well as during last twelve months. These behaviours and corresponding questions have been identified to constitute domestic violence based on previous studies in other settings [ 1 , 27 , 28 ]. The questionnaire for men included similar questions about his perpetration of violence against his wife (see Annexure 1b in Additional file 1 ). A multiphase process was used to develop these questionnaires to ensure that it was culturally and linguistically appropriate. These questionnaires were prepared initially in English and translated into the languages of the study states (Oriya in Orissa, Bengali in West Bengal and Hindi in Jharkhand). The questions, which were in above languages were back translated to English, by those who are not involved in this study to ensure semantic and content validity. The translated questionnaires were further reviewed for linguistic reliability and correctness by the study staff. Later the questionnaires were piloted to check appropriateness, clarity and flow of questions among some respondents, but from the villages that were not included in the study. In addition, piloting provided practice to the research staff, who collected data using these questionnaires.

All the interviews were held in local language of the state. Interviews took place in a private place in or outside the respondents' home, and care has been taken to avoid presence of other family/community members during interviews. If some one comes nearer during interview, the discussion on general health was made and the interview was restarted after the third person has retired. Interviewers stressed that honest responses were needed during interview to gain insight into the issue. Participants were assured of the confidentiality of their responses. To attain all these, care has been taken to establish rapport with every participant prior to interviews. Women and men were interviewed by women and men investigators, respectively. Individual verbal informed consent was obtained from all participants by explaining the purpose of the study. These field works were carried out during September 2004–July 2005.

The sample size was calculated based on the available estimated prevalence of domestic violence for these states [ 28 ]. Based on the prevalence of domestic violence, with a confidence level of 95% and absolute precision of 0.05, the samples required were: 450 women for Orissa, 740 women for West Bengal and 480 women for Jharkhand [ 29 ]. Same sample sizes were considered for men sample. Keeping in view of 70:30 ratio of rural and urban population, the samples were distributed accordingly. Multistage sampling strategy was used to attain the required samples (Figure 1 ). From each state, four districts were selected from different corners of the state. Out of these four districts, two each were allocated to draw rural and urban sample. From each district chosen for rural sample, two blocks (administrative units in the district) were selected randomly. From each block, two villages were randomly selected from the list of villages in the block. These two villages were considered for sampling of women participants. In addition, two more villages of similar type and size nearer to the selected village were identified and men were sampled from them. From each district allocated for urban sample, an urban area (a city or a town) was selected. In each urban area, sixteen pockets belonging to different socio-economic strata were identified. These strata were high-income group, middle-income group, low-income groups and slums and were identified based on the information obtained from the local key-informants and physical appearance of housing. Of these 16 pockets, eight (two each from each stratum) pockets each were allotted to sample male and female participants. Thus, from each state, 16 villages and 32 urban pockets were chosen for sampling of female and male participants.

Multistage sampling adopted for sampling of women and men .

After selecting the village/urban pocket, the research team met village/community heads and elders before initiating the data collection, and the purpose of the survey was explained. Rapport is established with the community and especially the women were taken to the confidence. The sample to be collected from each village was determined by dividing total rural sample required for that state by total number of villages (eight). In each village, eight random points were identified from all corners and care has been taken to include all communities. From each point, required number of sample was collected from households spread in four directions of the point. Similarly, in each urban pocket, participants were selected from the households spread in all the four directions. A married woman up to the age of 50 years of sampled household was sampled from each household. Corresponding to the women sample, married men aged below 50 years were selected in the similar way from the neighbouring village/urban pocket. Initially, 1753 women and 1730 men were contacted; however, 35 women and 15 men have refused to participate, yielding a refusal rate of 2% and 0.8% among women and men, respectively. Thus, samples of 1718 women and 1715 men were obtained.

Measurements

Outcome variables.

Three principle domestic violence outcome variables considered in our analysis are: physical violence, psychological violence and sexual violence. They were determined by response to a set of questions for each outcome variable. If a woman (as a victim)/man (as a perpetrator) gave a positive response to any of the questions in a set, it is considered as violence of that category. The questions used for women and men were listed in Annexure 1a and 1b, respectively in Additional file 1 . In addition, the fourth variable, i.e. any form of domestic violence was derived. If at least one of the three forms of domestic violence (physical and/or psychological and/or sexual) was present, it was considered as the presence of any form of domestic violence. During logistic regression analyses, these outcome variables were dichotomised into presence and absence of violence, for each type of violence.

Socio-economic variables

Data were collected on a number of community-level and individual-level variables that have been linked to domestic violence. The community-level variables included are the state of residence (Orissa, West Bengal or Jharkhand), residence (living in rural or urban), religion (Hindu, Muslim, Christian or any other religion) and caste. During the survey, individual caste of the respondent was collected and they were categorized subsequently during analysis. The Government of India had categorised some ethnic groups (castes and tribes) into scheduled castes, scheduled tribes and backward castes, and these categories are entitled for positive discrimination in educational, employment and other developmental opportunities for their upliftment. The uncategorized castes, which form the majority of the population, are often referred to as forward castes. The individual-level variables were: age in years (which was categorized into individuals less than 20 years of age, those between 20 and 29 years, and those above the age of 30 years), education, which was categorized in to illiterate (those who can neither read nor write), functional literate (those who can read or write, but did not have formal schooling), school education (1–10 years of schooling) and, college education and above (those having more than 10 years of education). The occupation of the participant was recorded and the responses were categorized into salaried jobs (those in permanent or temporary assured jobs with fixed monthly salary), farming and small business (those engaged in agriculture-related activity and small businesses), labourer (daily-waged skilled and unskilled labourers), housewives (only women) and other occupations. The monthly income of the family was calculated during data analysis based on the information collected on income of all members as well as from common sources of the family. The income details were collected in Indian Rupees (INR). One INR was equivalent to 0.02 United States Dollars (US$). For logistic regression, these variables were used as categorical variables, except the age. The categories under each variable were explained above. The age was taken as continuous variable.

Data Management and Analysis

The data were computerized through Epi-Info 6. The database of Epi-Info was exported to SPSS and further analysis was carried out. The prevalence with 95% confidence intervals (CI) of different forms of domestic violence reported by women and men were computed for each of the states. For the domestic violence prevalence reported by women, the associations with socio-economic variables (habitat, age, religion, caste category, education, occupation and family income) were examined by using both bivariate and multivariate procedures. For each of the group under a variable, the prevalences in the form of percentages were presented and bivariate logistic regressions were carried out. In addition, multiple logistic regression analysis was used to model the presence or absence of physical, psychological and sexual violence, and any form of domestic violence by all of the aforementioned socio-economic variables. For these logistic regression analyses, the dependent variables were dichotomised (presence or absence of violence). The independent variables were categorised into different groups as described under measurements. While calculating odds ratios (OR), the category with the lowest weight was taken as the reference category. The OR is the value by which odds of the event (occurrence of violence) change when the independent variable increases by one unit/step. And it has been calculated by adjusting for all other independent variables in multivariate models. A p value of less than 0.05 was considered as the minimum level of significance.

Ethical considerations

The study protocol has been approved by the Human Ethical Committee of Regional Medical Research Centre. Individual informed consent was obtained from all participants, as mentioned above. Guidelines of World Health Organization, including the importance of ensuring confidentiality and privacy, both as means to protect the safety of study participants and field staff, and to improve the quality of the data were followed [ 30 ].

Socio-economic characteristics of the participants

The details of socio-economic characteristics of sampled women and men participants were presented in Table 1 . Majority of women participants were in the age group of 20–29 years (60%) and men participants were in the age group of 30 years and above (75%). Most of the men and women participants were Hindu. A considerable number of women (6.5%) and men participants (18%) belonged to other than these three major religions. And most of them were from tribal religion, and some were from Sikhism, Jainism and Buddhism. Majority of the participants were from uncategorized castes (forward castes). Regarding educational status, about half of the participants were having school education. Majority of women participants were house-wives. With regard to income, majority participants possessed monthly family income of less than INR 2000 ( ≅ US$ 40).

Prevalence of different forms of domestic violence as reported by women and men

The prevalence of physical, psychological, sexual and any form of domestic violence in the life time of women were presented in Table 2 . The life time occurrence of physical violence reported by women was highest in Jharkhand (21.1%), followed by West Bengal (14.6%) and Orissa (13.2%). Psychological violence has been reported by slightly more than half of the women in all the states. Highest prevalence of sexual violence during the life time as reported by women was 32.4% in Orissa, followed by Jharkhand (27.4%) and West Bengal (19.7%). The overall prevalence of physical, psychological, sexual and any form of violence during the life time among Eastern Indian women were 16%, 52%, 25% and 56%, respectively.

Similarly, men were also interviewed to know whether they perpetrated any violence during their life time against their wives (Table 2 ). The perpetration of physical violence during their life time reported by men was highest in Jharkhand (26.4%), followed by Orissa (21%) and West Bengal (19.4%). Perpetration of psychological violence was also highest in Jharkhand (66%), followed by Orissa (62.7%) and West Bengal (53.1%). The sexual violence, as reported by men as perpetrator during their life time was 19.3% (in Jharkhand), 17.8% (in Orissa) and 15.1% (in West Bengal). Men reported slightly, but not significantly higher prevalence of physical and psychological violence than those reported by women. However, men reported lower prevalences of sexual violence compared to those reported by women.

Persons responsible for perpetration of domestic violence

It was probed from the women about the person, who actually perpetrated different violent behaviour. Table 3 reveals that husband was mostly responsible for violence among majority of women. Some women reported that in-laws (husbands' parents) were also responsible for few acts of violence, particularly of psychological violence. In Jharkhand, sibs of women's husband were also involved. Few cases of physical violence wherein in-laws and husbands' kins involved were reported from West Bengal and Jharkhand. One woman each from West Bengal and Jharkhand reported to be coerced to sex by their fathers-in-law.

Continuation of domestic violence

It was probed to know whether or not the reported behaviours of violence are continuing currently among the women, who reported the experience of different acts of physical, psychological and sexual violence during their lifetime. If it is continuing, it was further probed for each act to know the periodicity of their occurrence. It is probed to know whether they are experiencing these acts daily. It is found that, almost all acts of violence were still continuing among majority of women (Table 4 ). For example, the insult of women through abusive language is reported to be continuing among 41.3% of women of Orissa, where as 23.8% of women reported that they were experiencing daily. Similar situation was reported for all behaviours of violence, including sexual coercion which is continuing among 27% out of 31% of women of Orissa, 16% out of 19% of women of West Bengal and 22% out of 26% of women of Jharkhand. A majority of women reported that they were experiencing these acts of violence daily.

Prevalence of domestic violence by socio-economic characteristics of women

Table 5 illustrates the prevalence of various forms of domestic violence during the life time reported by women by different socio-economic characteristics. In each category, percentage of women experienced violence to the total number of women belonged to that particular category of socio-economic characteristic was given. The rural-urban differences were slightly visible. Urban women reported slightly higher prevalences of physical and psychological violence as well as overall domestic violence. However, the prevalence of sexual violence was slightly higher among rural women. Age has a profound association with the prevalence of domestic violence in these communities. Prevalences of all forms of violence were increased along with the age of the women. Women aged 20–29 years and aged above 29 years have reported higher prevalence of violence than women aged less than 20 years. The differences among various religious groups were not conspicuous. However, there were apparent differences across the groups categorised based on their caste/tribe affiliation. Women belonged to backward castes reported higher prevalence of any type of violence along with psychological and sexual violence. However, scheduled tribes also reported higher prevalences of all sorts of violence. The data revealed that education has impact on the prevalence of domestic violence. The prevalence of violence decreased as educational levels of women increased. Also, there were variations in the prevalence of violence across different occupational groups of women. Higher prevalence of violence was reported by women who were engaged in farming and small business. Women with lowest income reported highest prevalence of violence. However, the prevalences were higher among high-income groups than among middle-income groups.

The above associations were further examined through bivariate logistic regressions by taking presence or absence of violence as a dependent variable and women's socio-economic characteristic as a covariate (independent variables). OR along with levels of significance of regression models for all types of violence are shown in Table 6 . A significant association was found between presence of physical violence and women's characteristics namely, state, age, religion, caste, education and monthly family income. The psychological and sexual violence also showed significant association with these variables except with state and religion. Psychological violence yielded significant regression coefficient with women's occupation. The variable, any form of violence recorded significant regression coefficients with age, caste, education and monthly family income. The OR obtained for association of violence occurrence with education and income are below one and they revealed that the prevalence of violence decreases along with the increase of women's education and family income.

Further, multivariate logistic regressions were carried out to examine these associations, separately for each type of domestic violence (Tables 7 , 8 , 9 and 10 ). The physical violence has significant association with state, residence (rural or urban), age and occupation of women, and monthly family income (Table 7 ). The association between occurrence of physical violence and the family income was inverse, as occurrence of violence decreased with increasing family income. Psychological violence was significantly associated with residence, age, education and occupation of the women and monthly family income (Table 8 ). However, only residence, age and educational level of women were significantly associated with the occurrence of sexual violence (Table 9 ). Regression analysis for occurrence of any form of violence revealed that residence, age, educational level and occupation of women and monthly family income were significantly associated (Table 10 ).

In the present study, women reported as high as 56% of some form of violence against them in Eastern part of India. The levels of physical, psychological and sexual violence against women were also considerably high. These data along with the world-wide literature confirm that domestic violence is a universal phenomenon existing in all communities [ 8 , 12 , 31 ]. Also, it is confirmed that women were at more risk of violence by their husband than any other perpetrator. However, these figures should be understood cautiously as some of the behaviours considered as violent behaviour (such as coerced sex by husband-husband having sex with his wife when she is unwilling) may not be perceived by either partners or people as being inappropriate or wrongful [ 32 ]. However, irrespective of the people's perceptions, these behaviours have influence on both physical and mental health of women.

The present data demonstrated that in Eastern India, the domestic violence is persisting considerably across all socio-economic strata. Some characteristics of women namely, residence, age, education, occupation and family income have influence on the prevalence of domestic violence. The prevalence of violence decreased along with the increase of women's education and family income. However, no comprehensive studies are available from this part of India to compare these findings. One nation-wide study from India revealed that higher socio-economic status as a protective buffer against domestic violence [ 16 ]. The data from Uttar Pradesh, a north Indian state revealed similar results on association of domestic violence with socio-economic characteristics [ 12 , 33 ]. But these data were collected from the perspective of men. These studies revealed that higher levels of education among both husbands and wives and greater household wealth were found to be protective factors against the risk of physical violence. But no such association was evident with respect to sexual violence, and in fact women married to more educated men experienced significantly higher risk of coercive sex [ 34 ].

Some of the earlier studies from India revealed that though inadequate and failure of timely payment of dowry has been focused as an important reason for domestic violence in India, several other triggers of domestic violence such as negligence or failure in performing duties expected of women in the family also led to violence against women [ 10 ]. These causes reflect deep-rooted gender inequalities that persist across India. It is due to male patriarchy, which is defined as a system of male dominance legitimated by within the family and the society through superior rights, privileges, authority and power [ 35 ]. Socialisation of women into subordinate position and thinking of men that they are superior to women and have a right to control women are resultant phenomena of male patriarchy. Such socialisation leads to powerlessness of women, which ultimately leads to violence and inability of women to defend themselves [ 10 ]. Heise argued that violence is an extension of a continuum of beliefs that grants men the right to control women's behaviour [ 36 ]. Miller also suggested that low self-esteem among Indian girls contribute to the women's acceptance of violence by their husbands [ 37 ]. In addition, studies conducted during last ten years identified several community and individual level variables that determine the risk of domestic violence [ 34 , 38 ]. In the present study, urban women reported a higher prevalence of violence than rural women. As expected, living in urban areas is a higher risk factor than living in rural areas and as such, the current data corroborate results from other developing nations [ 39 , 40 ]. However, these findings do not confirm with the pattern in India [ 18 ]. Urban social environmental conditions can be more stressful, alienating, and anomic than do rural areas and such conditions may influence spousal relations [ 40 ]. In Indian communities, higher levels of income and education were found to be protective [ 16 , 41 – 45 ].

This study, along with the domestic violence rates based on the reporting of women, presented the prevalence of domestic violence reported by men, as perpetrator. These rates are in corroboration with those reported by women. Almost all research on domestic violence has relied on women's rather than men's report of their experiences [ 32 ]. Few studies have asked both partners of a couple about their experiences of domestic violence, and they yielded various degrees of consensus [ 46 , 47 ]. However, in the present study, the rates of physical and psychological violence reported by men were more than those reported by women, where as the rates of sexual violence were less than those reported by women. It may be due to the differences in the perceptions of men and women regarding certain behaviours as sexual violence. For example, husband may not perceive coercion as against the will of wife. In the present socio-cultural context, the initiator for sex is usually the husband. To larger extent, sex remained as a hidden subject of discussion even between wife and husband; and women are not expected to express their desire. This prevailing societal norm might have led men to think sex as prerogative of husband and wife is just expected to accept. Probably, men might not have perceived the sexual violence as perceived by women. Heise et al. felt that the meaning of such behaviour may not be perceived by either partner as being inappropriate or wrongful [ 32 ]. However, it is not out of context to note that forced sex within the marriage is considered as rape or sexual assault in many countries including several states in the United States. Recently, India, through the Protection of Women from Domestic Violence Act of 2005, recognised different forms of physical, sexual, verbal, emotional or economic abuse as domestic violence. Under this act, rape within the marriage is considered as a crime [ 48 ]. Previously it was impossible to prosecute a man for sexually raping his wife, which was considered to be within his conjugal rights. High level of normative support and limited/absence of community sanctions on violence against wife in these communities might have made men to report, and also these rates were comparable with those reported by women. A similar agreement between partners in reporting of physical violence was reported by other studies [ 49 , 50 ]. Hence, investigating men may be used as an element of validation of estimates of domestic violence. Also, it may be relied on the reporting of men in communities, where investigating women is difficult.

Methodological considerations

There are limitations in this study, as usual to this type of research topic. The topic of interview is very sensitive and participants may not express their views openly, as they think that their responses may damage the reputation of themselves and their families. Sometimes in this type of research, participants may also report the behaviour that is believed to be consistent with their culture, rather than the actual [ 51 ]. However, these were managed by the trained field staff by interviewing the participants alone. Like any study based on the self-reporting, there might be recall bias in disclosing the violent episodes. Since Indian women are usually stigmatized and blamed for the violence and abuse they receive, as well as for their husbands' violent behaviour, over-reporting of violence is unlikely. However, there is possibility of risk of potential bias as respondents' willingness to disclose their violence experiences vary across different socio-economic groups. Another limitation is the cross-sectional design itself, which do not allow for making conclusions focused on associations. It is difficult to make causal inferences. However, the direction of some of the associations like association of violence with women's caste and religion are expected. The associations between occurrence of violence and family income and women's occupation might be a 'both ways' association. Despite these limitations, the study had methodological strengths including use of standardized pre-tested instruments, inclusion of all groups of population, rigorous training to field workers and establishment of rapport with the study communities and participants.

The study confirms the high prevalence of all forms of violence against women across all socio-economic settings in eastern zone of India. However, urban residence, older age, lower education and lower family income are associated with occurrence of domestic violence. Women are at risk of violence from the husband than any other type of perpetrator. This situation has public health implications as public health can have a role in preventing the violence and its health consequences. Also, the primary healthcare institutions in India should institutionalise the routine screening and treatment for violence related injuries and trauma. These results also provide vital information to assess the situation to develop interventions as well as policies and programmes towards preventing violence against women. As India has already passed a bill against domestic violence, the present results on robustness of the problem will be useful to sensitise the concerned agencies to strictly implement the law.

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Acknowledgements

This study received financial and technical support from the Indian Council of Medical Research (ICMR), New Delhi, India. The authors acknowledge the support of Drs. Azad S. Kundu and Meerambika Mohapatra, Social and Behavioural Research Unit, ICMR, New Delhi. They also acknowledge and appreciate the fieldwork efforts of Mr. Biswaranjan Purohit, Mr. Satyendra K. Sahoo, Ms. Snigdha Mohapatra, Ms. Nirupama Bhuyan, Ms. Suchismita Mahakud and Ms. Vijaya Laxmi. The authors thank the participants and community leaders in study villages and urban pockets for their co-operation and courtesy during filed works.

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Both the authors contributed to the conception of the study design and development of study instruments. BVB involved in field works; coordinated in the data collection; computerized and analysed the data; interpreted the results; prepared the manuscript. Both the authors read and approved the final manuscript.

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Additional file 1: Annexure 1. A: Questions posed to women in this study to consider physical, psychological and sexual violence against women. B: Questions posed to men in this study to consider physical, psychological and sexual violence against their wives (DOC 39 KB)

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Babu, B.V., Kar, S.K. Domestic violence against women in eastern India: a population-based study on prevalence and related issues. BMC Public Health 9 , 129 (2009). https://doi.org/10.1186/1471-2458-9-129

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DOI : https://doi.org/10.1186/1471-2458-9-129

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Domestic violence cases dragging on like other family court matters: Top court

The supreme court expressed concerns over the slow pace of progress in the cases filed under the domestic violence act and questioned the lack of a support system for women even after nearly two years..

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• Supreme Court says only 710 dedicated protection officers appointed
• Demands states appoint protection officers to look into domestic violence cases
• Observes situation regarding Domestic Violence Act implementation was 'dismal'

With more than 4.7 lakh cases pending in the country under the Domestic Violence Act, the Supreme Court on Monday expressed concerns over the slow pace of progress in such cases and said a support system for women was not in place since the Act came into existence in 2005.

The Protection of Women from Domestic Violence (PWDV) Act was passed in 2005, with a mandate to ensure safe shelters and protection officers for women facing violence in their homes. The plea, filed by the NGO, 'We The Women of India', pointed out in 2021 that the "assistance system" framework was not in place nearly two decades later.

"There has to be an assistance network that needs to be set up- protection officers, health assistance, shelter homes etc. If a woman faces violence, where is she supposed to go?" senior advocate Shobha Gupta, appearing for the petitioner, argued.

Following this, a bench of Justice BV Nagarathna and Justice Pankaj Mithal issued a notice to all states and Union Territories (UTs) on a plea that sought court orders for the implementation of the support mechanism for battered women. The top court heard the issue after 18 months.

In February last year, the Supreme Court observed that the situation regarding the implementation of the Domestic Violence Act was "dismal". The court passed directions for consultation between the Centre and states to ensure that the systems required to provide help and shelter to women facing domestic violence were put in place.

On Monday, the bench questioned why the system had not yet been put in place.

"We find the Domestic Violence Act is proceeding as if it is a maintenance case or any other case before the family court. This is for a quick remedy. Implementation of the Act must be seen. Why is there a delay?" the bench asked.

Gupta, in her arguments, analysed the affidavit filed by the Centre in the matter on April 20 last year, where it was noted that there were only 3,637 protection officers in the country, with 2,655 of them having "additional charge" of the Domestic Violence Act implementation. Only 710 dedicated protection officers have been appointed across India.

The protection officers under the Domestic Violence Act are expected to provide support to the victims, monitor the case and assist the court hearing the Domestic Violence Act case, act as an "interface" between the victims, police and the judicial process. The court in 2023 noted that as per the available data, if there is only one protection officer in each district, they would be faced with over 500 "intensive" cases.

"Most states have given additional charges to revenue officers or IAS officers. So far, it seems that none of the states are 100 per cent compliant," Gupta said.

According to the policy, the number of protection officers in each district has to be fixed based on the number of cases and distress calls made by women.

However, the Centre's affidavit shows that most states admitted that they do not have an adequate number of protection officers. The states have also given suggestions during the consultation with the Centre, regarding the necessary minimum qualifications required for protection officers. However, these states have failed to appoint dedicated protection officers, and have given additional charge of the work to already overburdened revenue officials.

The petitioners have also pointed out that empirical study of the implementation of the Domestic Violence Act provisions, the number of distress calls, and manpower required has not yet been conducted by the Women and Child Development Ministry, even though the Supreme Court had passed directions in February 2023 to the WCD Secretary to call a meeting with all states and UTs, as well as the Finance, Home and Social Justice Ministries, National Commission for Women, NHRC and NALSA to consider the issue.

Additional Solicitor General Aishwarya Bhati also informed the court that the work of setting up 'One Stop Crisis Centres' and other assistance was being done under 'Mission Shakti'. The petitioners, however, argued that even that work has been slow.

According to the available data, only 733 One Stop Crisis Centres have been set up even though the Centre had sanctioned 801 such centres. Additionally, there is lack of awareness about the Domestic Violence Act and the assistance systems.

According to the Centre's own affidavit, the complete list of One Stop Crisis Centres, protection officers, and their contact details are supposed to be displayed prominently on the websites of the WCD ministry, NCW, NHRC and the official websites of the state human rights bodies. However, the links giving these details are not prominently accessible on the home pages of these government bodies.

The common portal and dashboard of Mission Shakti, which is expected to display the details of the helplines, support centres and the data regarding distress calls is also a "work under process" with the data currently not available for analysis.

"Protection officers must be appointed by the states," noted Justice Nagarathna. The bench, in its order, said, "Since the obligation for implementation rests not only with the government but also with states. We deem it necessary to issue notices to all states and Union Territories."

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