Population Council Research that makes a difference

2011 International Conference on Family Planning
29 November–2 December 2011

Abstract

"Reproductive health consequences of gender-based violence: A situational analysis in northern India"
Jaleel Ahmad

Violence against women has been recognized as an important public health problem around the world. The past two decades have seen a growing recognition of the prevalence and negative health consequences of domestic violence in India. Violence against women cuts across all socioeconomic groups, certain specific individual and socio-cultural factors put some women at higher risk of experiencing violence from their husbands than others.

This paper focus on (a) the prevalence of different forms of domestic violence and its impact on reproductive health of rural women in the state of Uttar Pradesh, and (b) health provider’s awareness of prevalence, harmful effects and prevention strategies against violence on married women by their husbands.

Methodology
A formative study was conducted covering a total of 4,754 households spread over 12 districts of UP, that is, 4 districts from each of the three regions (the Eastern, Western and Central regions) covering 225 villages. The survey covered a total 4,472 married women aged 15–34 years, who had delivered a child during the three years preceding the survey and 2,274 husbands. In addition, 724 frontline health workers such as ASHAs, ANMs and AWWs were also interviewed to understand their perspectives on domestic violence. The survey was performed from August 2009 using a semi-structured interviewer-administered questionnaire by trained investigators. In-depth interviews were also conducted with all stakeholders to complement the information gathered in the quantitative survey.

Findings
Twenty-three percent of women had started cohabiting before their fifteenth birthday. Among the total 4,223 women interviewed for this study, 37 percent reported that they had experienced any type of violence during the last 12 months from their husband. Among them 31 percent of women mentioned of experiencing emotional violence and 10 percent each said that they had experienced physical and sexual violence during the last 12 months. Regression analysis showed that certain socio-demographic characteristics such as caste, education and wealth index are significant predictors of domestic violence for women and those who are in the lower social strata are more vulnerable to experience violence in their family.

The severity of all type violence reduced during pregnancy as reported by 32 percent of women where as only a small percentage of women (1–2 percent) observed that the severity increase during pregnancy. A large majority of ASHAs (96 percent) and three-fourths (70 percent) of ANMS agreed that domestic violence does have an effect on women’s health. The most frequently reported health consequences of violence on women by almost half of ASHAs (48 percent) and 35 percent of ANMS were the danger for mother and child including possibility of abortion or still birth. Another important health consequence mentioned was the 'mental stress on women' due to violence. There is an overall impact violence on health behaviors of those women who reported violence, relatively lesser number of them went for three ANC check-up or institutional delivery, postnatal check-ups. In case of family planning the association between no violence and higher use of FP method was not significant.

Pregnancy is not a determinant of increased violence and it reduces during pregnancy. This could be utilized as window to sensitize men about adverse affect of domestic violence on health of a woman. Very few women (2–3 percent) reported that they receive advice on how to protect themselves against violence during their antenatal contacts with frontline health workers. Integration requires violence counseling being part of the antenatal care which further requires orientation of frontline health workers of risk of violence on reproductive health.

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