ENGL 1302 research paper

Journal of Clinical and Diagnostic Research. 2017 Oct, Vol-11(10): LC01-LC04 11

DOI: 10.7860/JCDR/2017/27386.10750 Original Article

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n Domestic Violence against Women – An Unsolved Issue: A Community Based

Study in an Urban Slum of Kolkata, India

IntrOductIOn Domestic violence is an alarming public health problem in all socio- economic and cultural population subgroups and in many societies including a male dominated developing Indian society. Violence against women causes severe deterioration in physical, mental health and adversely affects the quality of life. Women are socialized to accept, tolerate, and even rationalize domestic violence as well as to remain silent about such experiences.

According to National Family Health Survey (NFHS) - III, prevalence of any form of domestic violence on women after marriage in India was 39.7%. The highest prevalence was in the state of Bihar with 60.8%, while it was 41.8% in West Bengal [1]. Of these incidences, 63% were reported from urban families [2]. The battle against domestic violence was addressed globally by resolutions of various international forums including fourth World Conference on Women in 1995 in Beijing [3]. 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 [4]. Research across the world has provided increasing evidence on the problem of violence against women [5,6].

Women in slums are more vulnerable to domestic violence than the general population [7,8]. In backward areas like urban slums these incidents more frequently go unreported due to various socio- demographic factors [2]. Ergo, the focus of the researchers on this aspect should be more on this particular type of population. Current study was conducted with a greater sample size than the previous one [2] in an urban slum of Kolkata with objectives to estimate the prevalence of domestic violence among the ever married women in the reproductive age group (15-49 years) to assess the different types of domestic violence among them and to identify the covariates of the same.

MAtErIALS And MEtHOdS A descriptive, cross-sectional, community based study was undertaken in a slum of Kolkata under ward 132, borough 14 of Kolkata Municipal Corporation (KMC) catering a population of around 35,000. Duration of study was 6 months i.e., from July to December, 2015. The study area was an urban slum purposively chosen for the research. All the ever married women of reproductive age group (15-49 years) not having any psychiatric or serious medical illness at present were included in the study. Subjects who did not give informed consent were excluded from the study.

The subjects were interviewed with a pre-designed, pre-tested semi- structured schedule adapted from N.F.H.S Woman’s Questionnaire [9] after taking informed consent. In case of non response from any women, information was taken from the next willing woman.

Institutional ethical clearance was obtained before the study. Assurance about the anonymity and non-disclosure of the details of interview to husband/guardian were ensured. The schedule was first prepared in English and translated into Bengali by a linguistic expert keeping semantic equivalence. To check the translation, it was retranslated back into English by two independent researchers who were unaware of the first English version. Face validity of each item of the questionnaire had been checked from previous researches [1,2] in presence of public health experts. They also decided the content validity of each domain (Cronbach’s alpha 0.85). To check the reliability, it had been pretested to see clarity, absence of any ambiguity, objectivity and simplicity. Necessary corrections were made and the corrected version of the schedule had been pilot tested among 50 participants of the neighbourhood slum that was not included in the study to get the final corrected schedule. The sample size was calculated by taking the confidence interval of 95%, absolute precision of 5% and non-responsiveness

Jayita Pal1, tanJib HaSSan Mullick2, SHaMSHad aHMad3, aSHiSH kuMar yadav4

keywords: Female, Poverty areas, Spousal abuse

ABStrAct Introduction: Domestic Violence against women is still an unsolved issue in India, though, it is an important public health problem contributing to physical, mental illness and low quality of life.

Aim: The study was undertaken with the aim to estimate the prevalence of domestic violence against ever married women in an urban slum and the associated factors contributing to it.

Materials and Methods: A community-based cross-sectional study had been conducted among 430 ever married women of reproductive age group, selected using a systematic random sampling technique in an urban slum of Kolkata. Interviews were conducted using pre-designed, pre-tested semi structured schedule regarding their socio-demographic characteristics, violence experienced by the subjects in their lifetime, type of violence (physical, emotional and sexual violence) and the person responsible for the same. Data were entered and analysed using SPSS 20.0 version.

results: The overall prevalence of any form of violence in the study population as a whole was (59.3%). The prevalence of physical, emotional, sexual violence was 61.6%, 84.3%and 58.8%, respectively. The occurrence of the event was reported by only 33.1% of the victims. Multivariate analysis revealed violence was higher among women belonging to families with low per capita income (< Rs 3138 per month), with higher spousal age difference (>6 years), low educational background of husband, not able to bear a male child, unemployment amongst both the spouses, leave the household on any pretext without prior permission from husband and where the wives did not attend household activities properly.

conclusion: The prevalence of domestic violence in urban slum of Kolkata was high which is an alarming public health problem which needs to be addressed at the earliest through awareness programmes and empowerment of women.

Jayita Pal et al., Domestic Violence against Women – An Unsolved Issue www.jcdr.net

Journal of Clinical and Diagnostic Research. 2017 Oct, Vol-11(10): LC01-LC0422

10%. Therefore, the estimated sample size was 428. Each household of the study area was allotted a number and the samples were selected by using systematic random sampling technique. Data were entered in SPSS 20.0 version and analysed through descriptive and inferential statistics.

rESuLtS The current research was done after interviewing 430 ever married women in the reproductive age group (mean age – 30.58±9.97 years). Majority belonged to the age group of 15-24 years (36.7%). Among the study population, 76.7% were Hindu and 23.3% were Muslims. The mean spousal age difference and duration of marriage were 5.91±2.85 years and 13.19±10.19 years respectively. Regarding educational level, 31.9% of the subjects and 27% of the husbands were educated up to below primary level. Unemployment amongst husbands was 29.1%, whereas 34.9% of the subjects were employed. Majority belonged to joint family (79.5%) and lower middle and lower socio-economic class according to Modified B.G. Prasad scale [10] for the year 2016. Alcohol consumption in any form amongst the husbands was 74.9%. Social support was not found among 43.5% of the study population. Property in the form of land, money, ornament alone or in combination was found among 53.7% of the subjects.

type of violence number Percentage

Physical (current*) Often Sometimes

34 61

13.3 23.9

Physical (lifetime †) 156 61.2

Emotional (current*) Often Sometimes

49 119

19.2 46.7

Emotional (lifetime †) 215 84.3

Sexual (current*) Often Sometimes

18 67

7.1 26.3

Sexual (lifetime †) 150 58.8

Violence (any type) 255 59.3

[table/Fig-1]: Types of violence suffered by the victims (N =255)*(within last 12 months) † (throughout married life).

In the present study, the overall prevalence of any form of domestic violence was found in 255 (59.3%) of ever married women. The perpetrators were mostly the in laws including the spouse (59.6%). Emotional violence was more common than physical violence. As far as types of violence were concerned, 84.3% had emotional violence during lifetime (throughout married life), whereas 65.9% were subjected to current (within last 12 months) emotional violence. Regarding physical violence 156 (61.2%) of the subjects experienced it during lifetime; whereas 37.2% of them suffered from current physical violence. Regarding sexual violence, 58.8% of the subjects experienced it during lifetime, whereas 33.4% of them suffered from current sexual violence [Table/Fig-1]. Slapping (73.7%), kicking (62.8%), pushing (57.1%) were the most common forms of physical violence, whereas, insulting (80.8%), humiliating (73%) and threatening (60.5%) were the most common forms of emotional violence.

The occurrence of the event was reported by only 33.1% of the victims either to legal authority or friends, relatives, neighbours. The most common reason for not reporting was fear of social stigma (in 43.7%). Only, 8.45% had reported the event to the police, the remaining majority of the population had only shared it with relatives or friends.

Bivariate analyses revealed multiple factors leading to domestic violence. The event was significantly higher in the age group more than 29 years where the spousal age difference was more than 6 years, poor educational background (up to primary level), unemployment of both the partners, with low socio economic status

variables domestic violence test of significance Or ci

Present no (%)

absent no (%)

Age group* >29†

≤29 136(64.7) 119(54.1)

74(35.3) 101(45.9)

Chi square=5.069, df=1,p=0.024

1.560 1.058- 2.299

Spousal age difference* >6†

≤6 142(87.2) 113(42.7)

23(12.8) 152(57.3)

Chi square=79.420, df=1,p<0.001

8.305 5.020- 13.738

Education of women Upto primary level†

Above primary level 198(65.3) 57(44.9)

105(34.7) 70(55.1)

Chi square=15.529, df=1,p<0.001

2.316 1.518- 3.532

Education of husband Upto primary level†

Above primary level 213(80.3) 42(25.4)

52(19.7) 123(74.6)

Chi square=127.094, df=1,p<0.001

11.996 7.548- 19.064

Socio-economic status‡

Low§ Middle and above

203(86.3) 52(26.7)

32(13.7) 143(73.3)

Chi square=157.463, df=1,p<0.001

17.445 10.692- 28.465

Type of family Nuclear Joint

54(61.3) 201(58.8)

34(38.7) 141(41.2)

Chi square=0.195, df=1,p=0.650

1.114 0.689- 1.801

Religion Muslim Hindu

75(75) 180(54.6)

25(25) 150(45.4)

Chi square=13.304, df=1,p<0.001

2.5 1.514- 4.129

Employment of husband Not employed Employed

109(86.5) 146(48)

17(13.5) 158(52)

Chi square=54.656, df=1,p<0.001

6.939 3.970- 12.128

Employment of women Not employed Employed

213(76.1) 42(28)

67(23.9) 108(72)

Chi square=93.522, df=1,p<0.001

8.175 5.213- 12.819

Duration of marriage* ≤10†

>10 119(54.9) 136(63.9)

98(45.1) 77(36.1)

Chi square=3.616, df=1,p=0.057

0.688 0.467- 1.012

[table/Fig-2]: Distribution of study subjects according to different socio-demographic factors and their association with occurrence of domestic violence (N=430). *In completed year †Median value ‡ SES measured by modified B.G. Prasad scale (2016) §Lower middle and lower class

and among Muslims [Table/Fig-2]. Despite the above covariates some other risk factors came into light by studying the opinions of the subjects regarding the possible causes of their sufferings such as not cooking, not attending household properly, talking to others, alcohol addiction of the husband, not having male child, going out without permission, dowry and property issues, not having any social support, paranoid behaviour of the husband [Table/Fig-3].

Subsequently, multivariate logistic regression was applied to find out the association of domestic violence with the factors which were statistically significant in the bivariate analysis.

Multivariate analysis revealed violence was higher among women belonging to a family of lower SES with a male child preference, when the spousal age difference was more than six years, having low educational background of husband, unemployment amongst both the spouses, not attending household activities and going outside without permission [Table/Fig-4].

dIScuSSIOn Domestic violence is multidimensional and multifactorial, ergo prevalent in all societies of the world. Risk factors vary with geographical boundaries and socio-demographic pattern. Dey F et al., showed a trend of ever increasing tendency of crime against women in Kolkata [11]. The prevalence of lifetime physical and emotional violence was found to be 35.7% and 64.9% respectively in a study conducted in Kerala [12].

A study by International Centre for Research on Women (ICRW) [13] covering rural and urban slum and non-slum areas in 7 cities in India found the prevalence of physical and emotional violence to be 40.3% and 43.5%, respectively. Ramirez JC et al., found prevalence of domestic violence among urban population in India as 57% [14], whereas, Jewkes R et al., showed its lifetime prevalence to be 24.6% in South Africa [15].

www.jcdr.net Jayita Pal et al., Domestic Violence against Women – An Unsolved Issue

Journal of Clinical and Diagnostic Research. 2017 Oct, Vol-11(10): LC01-LC04 33

suffered from both current and lifetime physical and psychological violence [2].

In comparison with the above studies the current study showed a relatively higher prevalence of lifetime physical (61.2%) and emotional violence (84.3%).

Dowry and low education were recognised risk factors of domestic violence in previous studies [8,12], though dowry was not found as a risk factor in the current study. Low levels of education, unemployment of both the partners, alcohol consumption by the husband, lower socio-economic status and absence of social support of the wife were significant factors contributing to domestic violence as shown by Sinha A et al., and Saradamoni K et al. [2,12].

Women in every sphere of life are facing violence not only by their spouse but also by members of paternal home, sometimes by friends, teachers and in their work place too. The current study had focussed mainly on spousal violence. Further studies would help in understanding the violence against women by others apart from the spouses. There is also a need for in depth qualitative research to find out all the hidden contributory factors of violence against women.

LIMItAtIOn The present study could have been hindered by wilful falsification of data by some of the participants as well as inclusion of a single slum, that too without any proper sampling technique for which it might not represent the true scenario for the whole of Kolkata.

cOncLuSIOn More than half of the study subjects experienced domestic violence of any kind throughout their married life with emotional violence being the most common one. The perpetrators were mostly the in laws and the spouse. The current study showed an inverse relation of domestic violence with education of husband, employment, socio- economic status and gender preference. The event was found to be higher among the women when the spousal age difference was more and who did not attend household activities and go outside household without prior permission from the husband.

The prevalence of domestic violence in the present study was relatively higher than other studies of this kind. The women in the slums were habituated with the violent behaviour of their husbands in day-to-day life and keeping silence on the issue. They were forced to sexual relationship as it was the only means of entertainment of their partners. They have well accepted this violence as a normal phenomenon in their regular life. Therefore, they ignore this sort of violent behaviour of their husbands, thus, leading to under-reporting of the event. This issue needs to be addressed urgently through continuous IEC, appropriate utilisation of the legislations, proper reporting of the events to a legal authority, women empowerment and change in the attitude of the perpetrators towards the subjects.

AcknOwLEdgEMEntS The study would not have been successful without the active participation of the people of the slum. There were no financial or other competing interests.

rEFErEncES Ministry of Health and Family Welfare, Government of India. Fact Sheet: National [1]

Family Health Survey (NFHS) III 2005-06. Sinha A, Mallik S, Sanyal D, Dasgupta S, Pal D, Mukherjee A: Domestic violence [2]

among ever married women of reproductive age group in a slum area of Kolkata. Indian J Public Health. 2012;56(1):31-36.

United Nations: The Fourth World Conference on Women, Beijing, China, New [3] York: United Nations; 1995.

Kaur R, Garg S. Addressing domestic violence against women: An unfinished [4] agenda. Indian J Commun Med. 2008;33(2):73-76.

Heise L, Ellsberg M, Gottmoeller M. A global overview of gender based violence. [5] Int J Gynaecol Obstet. 2002;78(suppl 1):S5-14.

variables domestic violence test of significance Or ci

Present no (%)

absent no (%)

Not cooking Yes No

147(71.8) 108(48)

58(28.2) 117(52)

Chi square=24.980, df=1,p<0.001

2.746 1.839- 4.100

Not attending household Yes No

167(72.9) 88(43.8)

62 (27.1) 113(56.2)

Chi square=37.674, df=1,p<0.001

3.459 2.311- 5.177

Talking to others Yes No

172(70.4) 83(44.7)

72(29.6) 103(55.3)

Chi square=29.263, df=1,p<0.001

2.965 1.989- 4.418

Dislike by husband Yes No

95(62.5) 160(57.6)

57(37.5) 118(42.4)

Chi square=0.996, df=1,p=0.318

1.229 0.819- 1.844

Alcohol addiction Yes No

191(76.1) 64(35.8)

60(23.9) 115(64.2)

Chi square=70.456, df=1,p<0.001

5.720 3.753- 8.718

Dowry related issue Yes No

155 (72.4) 100(46.2)

59(27.6) 116(53.8)

Chi square=30.420, df=1,p=0.650

3.047 2.039- 4.554

Male child preference Yes No

166(72.4) 89(44.2)

63(27.6) 112(55.8)

Chi square=35.297, df=1,p<0.001

3.316 2.218- 4.956

Property related issue Yes No

137(69.6) 118(50.7)

60(30.4) 115(49.3)

Chi square=15.798, df=1,p<0.001

2.225 1.495- 3.312

Social support of wife No Yes

123(65.8) 132(54.3)

64(34.2) 111(45.7)

Chi square=5.745, df=1,p=0.017

1.616 1.090- 2.396

Going out without permission Yes No

178(75.1) 77(39.9)

59(24.9) 116(60.1)

Chi square=54.639, df=1,p<0.001

4.545 3.010- 6.862

Husband paranoid Yes No

107(66.4) 148(55)

54(33.6) 121(45)

Chi square=5.463, df=1,p=0.019

1.620 1.080- 2.431

[table/Fig-3]: Distribution of study subjects according to other relevant factors and their association with occurrence of domestic violence (N=430).

variables* b Sig Exp(b) 95% ci for Exp (b) lower upper

Spousal age difference 1.800 p<0.001 6.052 2.812 13.026

Education of husband 1.002 0.029 2.724 1.108 6.696

Socio-economic status 1.693 p<0.001 5.434 2.350 12.565

Employment of husband 0.961 0.038 2.614 1.054 6.483

Employment of wife 1.995 p<0.001 7.349 3.579 15.091

Not attending household 0.786 0.021 2.194 1.124 4.283

Male child preference 0.864 0.023 2.373 1.129 4.987

Going outside without permission

0.996 0.004 2.708 1.387 5.289

Constant -4.413 p<0.001

[table/Fig-4]: Multivariate analysis showing association of domestic violence with different factors. Hosmer Lemeshow test (p=0.708), Nagelkerke R2=0.718. B = slope of the gradient in logarithmic scale, Exp (B) = antilog of B Dependant variable is occurrence of domestic violence. All the independent variables are categorical. Spousal age difference up to 6 years, education of husband above primary level, high SES, employment of both the spouses, attending household adequately, no gender preference and going out with permission were the reference category. *Adjusted for age of the subjects, education of the victims, religion, not cooking, talking to others, alcohol addiction, dowry, property related, social support of wife, husband paranoid.

The prevalence of lifetime and current domestic violence was 56% and 27%, respectively, in a study conducted in slums of Bangalore [7], whereas, in urban slum of Nagpur [8] physical violence was found to be 66%.

A study in urban slum area of Kolkata by Sinha A et al., showed overall prevalence of domestic violence to be 54%, of which 41.9%

Jayita Pal et al., Domestic Violence against Women – An Unsolved Issue www.jcdr.net

Journal of Clinical and Diagnostic Research. 2017 Oct, Vol-11(10): LC01-LC0444

Heise L, Ellsberg M. Ending violence against women Baltimore, MD: John [6] Hopkins University Press; 1999.

Rocca CH, Rathod S, Falle T, Rohini P, Pande RP, Krishnan S. Challenging [7] assumptions about women empowerment: Social and economic resources and domestic violence among young married women in urban South India. Int J Epidemiol. 2008;38:577-85.

World SAFE pilot studies. Available from: http://www.inclen.org./research/[8] ws.html [Last accessed on 2016 Oct15].

National Family Health survey, India 2015-2016 (NFHS-4) woman’s questionnaire [9] available from http://rchiips.org/NFHS/NFHS4/schedules/NFHS-4Womans.pdf [last accessed on 2015 oct 10].

Vasudevan J, Mishra AK, Singh Z. An update on B.G. Prasad’s socioeconomic [10] scale. Int J Res Med Sci. 2016;4(9):4183-86.

Dey F, Modak S. Crime against women in Kolkata: a spatial difference and [11] temporal change analysis. International Journal of Science, Environment. 2015;4(4):1139-52.

Saradamoni K. Kerala Society and Politics: International Congress on Kerala [12] Studies. Vol. 1. AKG Centre for Research Studies. 1994. Available from: http:// www.cds.edu/download_files/344.pdf [Last accessed on 2015Oct 10].

Burton B, Duvvury N, Varia N. Domestic violence in India: A summary report of [13] four records studies. 2000. Available from: http://www.icrw.org/docs/DV2.pdf [Last accessed on 2015 Oct 10].

Ramirez-Rodriguez JC, Uribe-Vazquez G. [Women and violence:an everyday [14] fact]. Salud Publica Mex. 1993;35(2):148-60.

[15] Jewkes R, Levin J, Penn-Kekana L. Risk factors for Domestic Violence: Findings from a South African Cross-sectional study. Soc Sci Med. 2002;55(9):1603-17.

AppEndIx:

Questionnaire: Part 1: Socio demographic characteristics

1. What is your age? (in completed years)

2. How long you are married? (in completed years)

3. What is the age difference between you and your husband?

4. What type of family do you belong?

5. What religion do you belong?

6. What is your total monthly family income?

7. How many members are there in your family?

8. What is your education? (Illiterate/ Just literate/ Below primary/ Primary/Middle/secondary/Higher secondary/Graduate and above)

9. What is your husband’s education? (Illiterate/ Just literate/ Below primary/Primary/Middle/secondary/Higher secondary/ Graduate and above)

10. Is your husband employed? Y/N

ParticularS OF cOntributOrS: 1. Tutor, Department of Community Medicine, ESI-PGIMSR, ESIC Medical College, Joka, Kolkata, India. 2. Tutor, Department of Community Medicine, ESI-PGIMSR, ESIC Medical College, Joka, Kolkata, India. 3. Assistant Professor, Department of Community Medicine, ESI-PGIMSR, ESIC Medical College, Joka, Kolkata, India. 4. Assistant Professor, Department of Community Medicine, ESI-PGIMSR, ESIC Medical College, Joka, Kolkata, India.

naME, addrESS, E-Mail id OF tHE cOrrESPOndinG autHOr: Dr. Tanjib Hassan Mullick, Tutor, Department of Community Medicine, ESI-PGIMSR, ESIC Medical College, Village- Ekshara, P.O-Chamrail, District- Howrah, Kolkata-711114, India. E-mail: [email protected]

Financial Or OtHEr cOMPEtinG intErEStS: None.

Date of Submission: Feb 08, 2017 Date of Peer Review: apr 17, 2017 Date of Acceptance: aug 09, 2017

Date of Publishing: Oct 01, 2017

If yes, what kind of work he does?

11. Are you employed? Y/N

If yes, what kind of work you do?

12. Is your husband addicted to alcohol? Y/N

13. Do you have any social support? Y/N

14. Do you have any property? Y/N

15. If yes, what? Money/ land/ ornament/ others

Part 2: related to domestic violence

1. Have you ever experienced domestic violence throughout your married life? Often/sometimes/never

If yes which type? Physical/ emotional/ sexual (Often/some- times/never)

2. Have you experienced domestic violence during last 12 months?

Often/sometimes/never

If yes which type? Physical/ emotional/ sexual (Often/some- times/never)

3. Who is responsible for the violence?

4. What type of physical violence you have experienced? Pushing/slapping/ twisting hair/ pulling arms/punching/kicking/ chocking/burning/threatening of attack

5. What type of emotional violence you have experienced? Humiliating/insulting/threatening

6. What type of sexual violence you have experienced? Forced intercourse/ forced sexual acts

7. Have you ever reported this event if you experienced? Y/N

If yes, to whom?

8. According to your opinion, what may be the possible cause/ causes for this violence?

Not cooking properly/ not attending household/talking to others without permission/husband dislikes her/alcohol addiction of your husband/dowry related/not being able to bear a male child/property related/ social support related/ going outside household without prior permission from husband/ husband paranoid/ any other (specify)

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