Intimate Partner Violence (IPV) and Household Decision Making: Dynamics among Married Couples in India Archana More Sharma, PhD APHA Roundtable Presentation Denver, CO, November 7,

METHODOLOGY Data Source National Family Health Survey-3 ( ) – Nationally representative sample from all states – Stratification, clustering, sample weights – Over 124,000 women (15-49) & 74,000 men (15-54) – 3 questionnaires ; Individual surveys 39,250 matched couples – Analytical sample: Raw N=23,318, Weighted N=219,223 Variables Dependent Variable – Lifetime experience with any form of IPV (Physical, sexual, emotional) – 12 original questions – Operationalization: Dichotomous variable, Yes/No Independent variables – Household, individual, personal power, partner & relationship – Household Decision Making Agency 3 individual questions asked of men and women Summative score for decision making perceptions – Number of sole decisions made by women alone – Number of sole decisions made by the husband alone – Number of decisions made jointly 2

RESULTS: Descriptive Statistics Dependent Variable: IPV 3 Percent (%)Weighted N Experience with IPV Any IPV37.983,136 Emotional violence13.730,077 Physical violence34.074,626 Sexual violence7.616,560

RESULTS: Descriptive Statistics Women’s personal power: Decision Making Perceptions 4 CharacteristicsPercent (%) Weighted N # Sole HH decisions made by Wife , , , ,020 Husband , , , ,603 Jointly , , , ,472

RESULTS: Descriptive Statistics Men’s Decision Making Perceptions 5 CharacteristicsPercent (%) Weighted N # Sole HH decisions made by Wife , , , ,626 Husband , , , ,601 Jointly , , , ,630

RESULTS: Logistic Regression Models 6 CharacteristicsReg. coefficients Residence Rural Ref Urban 0.05 (0.07) Family structure Extended Ref. Nuclear 0.20 (0.04) * Wealth Poorest Ref. Poorer -0.12(0.07) Middle -0.33(0.07) * Richer -0.48(0.08) * Richest -0.95(0.10) * Woman’s education No education Ref. 1-5 years -0.18(0.06) 6-8 years 0.40(0.07) * 9-12 years -0.57(0.07) * 13 or more Household decisions: Woman alone 0.19(0.04)* Husband alone 0.04(0.03) Joint 0.04(0.03) * p<0.001

RESULTS: Logistic Regression Models 7 Has a bank account-0.585*-0.287* * Sole health decisions * Does not justify IPV-0.455*-0.372*-0.291*-0.239*- Supports ability to refuse sex-0.213*-0.256*-0.235*-0.300*- Household decisions: Woman alone0.192* Decisions on his earnings: Husband aloneRefRef. Joint-0.246*-0.294*-0.310*-0.257*- Wife alone Someone else/None Model 1Model 2Model 3Model 4Model 5 Characteristics Personal Power HouseholdIndividualPartnerRelationship * p<0.001

RESULTS Financial Decision Making Perceptions 8 CharacteristicsPercent (%)Weighted N Wife: Financial decisions on husband’s earnings Wife5.411,729 Husband23.150,662 Jointly ,892 Someone else5.712,445 He has no earnings1.12,495 Husband: Financial decisions on his earnings Wife2.24,866 Husband24.052,709 Jointly ,770 Someone else2.14,552 He has no earnings7.917,327

RESULTS Logistic Regression Analyses: Financial Decision Making Perceptions 9 Has a bank account-0.585*-0.287* * Sole health decisions * Does not justify IPV-0.455*-0.372*-0.291*-0.239*- Supports ability to refuse sex-0.213*-0.256*-0.235*-0.300*- Household decisions: Woman alone0.192* Decisions on his earnings: Husband aloneRefRef. Joint-0.246*-0.294*-0.310*-0.257* Wife alone Someone else/None Model 1Model 2Model 3Model 4Model 5 Characteristics Personal Power HouseholdIndividualPartnerRelationship * p<0.001

10 Low risk High risk Percent (%) IPV Prevalence Women’s Sole Household Decision Making (Percent of women who make at least one household decision alone) RESULTS: Geographic Variation Percent (%)

STRENGTHS AND LIMITATIONS Limitations Cross-sectional data Abstract concepts: gender norms, power, agency ‘Power’ from a western perspective Couple perceptions – interpretations Strengths Large sample size, nationally representative Men’s responses on their perceptions and behaviors Matched-couples dataset: couple dynamics Combined individual perceptions of men and women with relationship characteristics to examine a complex, multifaceted problem 11

PUBLIC HEALTH IMPLICATIONS Women’s Empowerment – Gender norms Need to understand the traditional gender roles of men and women and marital dynamics in terms of decision making agency IPV research – Involve men – Study couples, interpersonal dynamics 12