Global measurement of intimate partner violence to monitor Sustainable Development Goal 5

Abstract

BackgroundOne third of women experience intimate partner violence (IPV) and potential sequelae. Sustainable Development Goal (SDG) 5.2—to eliminate violence against women, including IPV—compels states to monitor such violence. We conducted the first global measurement-invariance assessment of standardised item sets for IPV.MethodsDemographic and Health Surveys (DHS) from 36 Lower−/Middle-Income Countries (LMICs) administering 18 IPV items during 2012–2018 were included. Analyses were performed separately for two items sets: lifetime physical IPV (seven items) and controlling behaviours (five items). We performed country-specific exploratory and confirmatory factor analyses (EFA/CFA). Datasets meeting benchmarks for acceptable item loadings and model-fit statistics were included in multiple-group CFA (MGCFA) to test for exact measurement invariance. Based on findings, alignment optimization (AO) was performed to assess approximate measurement invariance (< 25% of model parameters non-invariant). For each item set, national rankings based on AO-derived scores and on prevalence estimates were compared. AO-derived scores were correlated with type-specific IPV prevalences to assess correspondence.ResultsNational rates of physical IPV (5.6–50.5%) and controlling behavior (25.9–84.7%) varied. For each item set, item loadings and model-fit statistics were adequate in country-specific, unidimensional EFAs and CFAs. Both unidimensional constructs lacked exact invariance in MGCFA but achieved approximate invariance in AO analysis (12.3% of model parameters for physical IPV and 6.7% for controlling behaviour non-invariant). For both item sets, national rankings based on AO-derived scores were distributed similarly to rankings based on prevalence. However, estimates often were not significantly different cross-nationally, precluding national-level comparisons regardless of estimation strategy. Three physical-IPV items (slap, twist, choke) and two controlling-behaviour items (meet female friends; contact with family) warrant cognitive testing to improve their psychometric properties. Correlations of AO-derived scores for physical IPV (0.48–0.66) and controlling behaviours (0.49–0.87) with prevalences of lifetime physical, sexual, psychological IPV as well as controlling behaviour varied.ConclusionsSeven DHS lifetime physical-IPV items and five DHS controlling-behaviour items were approximately invariant across 36 LMICs spanning five world regions, such that cross-national comparisons of factor means are reasonable. Measurement-invariance testing over time will inform their utility to monitor SDG5.2.1; cross-national, cross-time measurement-invariance testing of improved sexual and psychological IPV item-sets is needed.