Mixed methods assessment of women\u2019s risk of intimate partner violence in Nepal

Cari Jo Clark,Susi Mcghee,Brian Batayeh,Gemma Ferguson,Stella Chang,Prabin Nanicha Shrestha,Binita Shrestha,Irina Bergenfeld

doi:10.1186/s12905-019-0715-4

Abstract

BackgroundIntimate partner violence (IPV) is a significant public health issue that affects one in three women globally and a similarly large number of women in Nepal. Although important policy and programmatic steps have been taken to address violence against women in Nepal over the past decade, there is still a gap on IPV research in Nepal, particularly with regard to social norms.MethodsThis mixed-methods study used in-depth interviews with women and their husbands as well as baseline survey data from a cluster randomized trial testing a primary prevention intervention for IPV to examine the prevalence and risk factors for IPV. Baseline survey data included 1800 women from Nawalparasi, Chitwan, and Kapilvastu districts in Nepal. Multivariate regression was used to identify risk and protective factors for exposure to physical and / or sexual IPV in the prior 12 months. Case-based analysis was used to analyze one of 18 pairs of in-depth interviews to examine risk and protective factors within marriages.ResultsOf 1800 eligible participants, 455 (25.28%) were exposed to IPV. In multivariate analyses, low caste, wife employment, income stress, poor marital communication, quarrelling, husband drunkenness, exposure to IPV as a child, in-law violence, and gender inequitable normative expectations were associated with IPV. The selected case interview represented common themes identified in the analysis including the wife’s exposure to violence as a child, husband alcohol use, and marital quarrelling.ConclusionsGender inequitable norms in the community and the intergenerational transmission of attitudes and behaviors supportive of IPV are important to address in intervention measures.

Highlights

Intimate partner violence (IPV) is a serious public health issue and a violation of human rights, affecting one in three women globally [1]
We contextualize risk and protective factors identified in survey data through analysis of in-depth interviews with couples in Nepal. Overview This analysis relies on data from the Change Starts at Home trial, which had the overall goal of reducing the occurrence of intimate partner violence through a social behavior change communication (SBCC) intervention which includes radio programming, listening and discussion groups (LDGs), and community outreach on physical and / or sexual IPV (NCT02942433) in three districts in Nepal (Nawalparasi, Chitwan, and Kapilvastu)
Considering couple relations, we found that couples who quarreled were more likely to be exposed to IPV, and that husbands who were drunk frequently were more likely to perpetrate IPV

Summary

Introduction

Intimate partner violence (IPV) is a serious public health issue and a violation of human rights, affecting one in three women globally [1]. In light of the health, social, and economic costs of IPV, there have been calls for better data on its prevalence, causes, and consequences to improve interventions aimed at addressing of violence against women and girls (VAWG) [15]. This global pressure led to the Sustainable Development Goal (SDG) 5.2, which calls for the. In Nepal, as elsewhere, traditional gender norms reinforce aggression and dominance among men [34], increase acceptance of partner violence [34], and act as barriers to education and employment for women, increasing women’s risk of IPV [23, 26]

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