Training Workshop for Field Staff Survey module on Violence against Women Developed for United Nations Economic Commission for Europe Rev. 29 April 2011

I. Introduction to the Workshop

Goals of the workshop To increase knowledge about gender based discrimination and violence To understand the goals and methods of the Survey on Violence against Women To develop interviewing skills To become proficient in the use of the survey questionnaire/module

Workshop Program Your input is very valuable! [Two weeks long] Theory and practice, including field pilot Changes may be made to questionnaire during the process Your input is very valuable!

Field work – immediately following the training!

Ground Rules Regular attendance Be respectful Ask for help when you don’t understand Listen without judgement or criticism Be willing to challenge your beliefs Honor confidentiality No one is required to share more than they want to

II. Sex and Gender

Defining Sex and Gender Sex refers to the biological differences between men and women. They are generally permanent and universal. Gender refers to the social relations between men and women. It therefore refers not to men or women but the relationship between them, and the way this is socially constructed. Gender roles can be changed.

III. Violence against women

What is violence against women? “ any act of gender-based violence that results in, or is likely to result in, physical, sexual, or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life". (United Nations, 1993)

Violence against women includes: partner abuse, sexual abuse of girls rape, including marital rape dowry related violence female genital mutilation trafficking in women forced prostitution sexual harassment at the workplace violence condoned or carried out by the state (i.e. rape in war)

Definition of domestic violence A pattern of assaultive and coercive behaviors, including physical, sexual and psychological attacks, as well as economic coercion, used by adults or adolescents against family members, most commonly against their current or former intimate partners.

Woman interviewed in Peru “So I take a blanket and I spend the night with my children out in the cold because he is hitting me too much. I have to take the kids to stop him hitting them too. I would go out in the fields and sleep there all night. I have done that more than ten times…” Woman interviewed in Peru

Common types of abusive behaviors Physical abuse Sexual abuse Psychological abuse Use of economics Use of children to control an adult victim

Examples of physical abuse Slapping Shaking Beating with fist or object Strangulation Burning Kicking Threats with knife or gun

Examples of sexual abuse Coerced sex through threats or intimidation Coerced sex through physical force Forcing unwanted sexual acts Forcing sex in front of others Forcing sex with others

Examples of psychological abuse Isolation from others Excessive jealousy Control her activities Verbal aggression Intimidation through destruction of property Harassment or stalking Threats of violence Constant belittling and humiliation

Examples of economic abuse With-holding funds Spending family funds Making most financial decisions Not contributing financially to the family Controlling the victim’s access to health care, employment, etc.

Examples of using children to control an adult victim Physical and sexual abuse of children Hostage taking of children Custody battles Using children to monitor the adult victim

How common is physical or sexual violence in women’s lives?

How common is partner violence? In most sites, 4 out of 5 women who have been abused (by anybody: partners and others) reported being abused by a partner. Between 15% (Japan) and 71% (Ethiopia) of ever- partnered women experienced physical or sexual violence by an intimate partner Source WHO study 2005

Pregnancy is not necessarily a protected time “He hit me in the belly and made me miscarry two babies - identical or fraternal twins, I don’t know. I went to the hospital with heavy bleeding and they cleaned me up” Woman interviewed in Peru In most sites 4%-12% of women who had been pregnant were beaten during a pregnancy In almost 100% of cases the abuser was the father of the unborn child Between one-quarter to half of these women reported being punched or kicked in the stomach Source WHO study 2005

Physical violence usually occurs together with sexual and emotional violence Globally, one-third to one-half of all physically abused women also report sexual violence Almost all physically abused women also experience severe emotional abuse

IV. Causes and Consequences of Violence against Women

An ecological framework for understanding violence Society Community Relationship Individual

Violence is learned behavior Boys growing up in families where father is violent are more likely to become perpetrators of partner violence in their adulthood.

Domestic violence is learned behavior: learned through observation learned through personal experience learned in culture learned in family, learned in communities, schools, friends, etc.

It may be aggravated, but not caused by illness heredity alcohol and drugs lack of self-control economic problems anger/stress the victim’s behavior or problems in the relationship

Violence against women is a product of gender subordination Four issues are consistently associated with societies with high levels of domestic violence: norms of male entitlement/ownership of women male control of wealth in the family notions of masculinity tied to male dominance/honor male control of decision making

Cultural differences in the meaning of violence: In large parts of the developing world, wife beating is seen as a form of “correction” or chastisement Beating is acceptable as long as it is for “just cause” Acceptability depends on who does what to whom, for what reason

Beating as discipline “I think that if the wife is guilty, the husband has the right to hit her…If I have done something wrong…nobody should defend me. But if I haven’t done something wrong, I have a right to be defended.” -- Indigenous woman, Mexico “If it is a great mistake, then the husband is justified in beating his wife. Why not? A cow will not be obedient without beatings” -- Rural man, Tamil Nadu, India

Health Consequences of Abuse For example: unwanted pregnancy chronic pain syndromes injury depression alcohol/drug use STDs/HIV Irritable bowel syndrome gynecological disorders Fatal Outcomes homicide suicide maternal deaths Aids related deaths Non-fatal outcomes physical mental injurious health behaviors reproductive health

Other consequences of violence For women: own health financial status ability to work ability to function participate in society For children: low birthweight emotional well-being behavioural difficulties problems at school injuries leave home

Conclusion Domestic and especially partner violence against women affects many women around the world -- with grave consequences for them and their children

V. Support for women living with violence

Many women internalize social norms justifying abuse “My husband slaps me, has sex with me against my will and I have to conform. Before being interviewed I didn't really think about this. I thought this is only natural. This is the way a husband behaves.” Woman interviewed in Bangladesh

Some of the barriers to leaving for domestic violence victims Fear for more violence Fear for her children Thinks it is normal/that he will change Economic dependence Family honor/not wanting to shame the family Lack of safe alternatives Lack of community/ family support Women are overwhelmed from physical and psychological trauma

Silence and stigma Many women never talk about domestic violence with anybody “I went to my mother first..... I told little by little. Her reaction was ‘Didn’t we tell you?’ ‘You brought this upon yourself, now you pay for it’, ‘There is the child, what will you do? Where will you go?’ and so on ....” Woman interviewed in Turkey

Coping & retaliation Women experiencing violence may utilise a range of strategies to try to minimise or end violence Actions to prevent or reduce violence include leaving & retaliation People may intervene to stop violence When severe, may turn to formal and informal sources of support Different levels of satisfaction with response May be others from whom would like to get support

Domestic Violence Laws in [country] [to be completed]

Resources for victims of violence in [country] [to be completed]

VI. Survey on VAW Goals Study Structure Design Sample Main Themes

Study goals To obtain reliable estimates for the main indicators of violence against women To obtain an impression of the extent to which violence is not reported to authorities

Required indicator outputs (core set) 1 Total and age-specific rate of women subject to physical violence in the last 12 months by severity of violence, relationship to perpetrator(s) and frequency Total and age -specific rate of women subject to physical violence during lifetime by severity of violence, relationship to perpetrator(s) and frequency Total and age-specific rate of women subject to sexual violence in the last 12 months by severity of violence, relationship to perpetrator(s) and frequency Total and age-specific rate of women subject to sexual violence during lifetime by severity of violence, relationship to perpetrator(s) and frequency

Required indicator outputs (core set) 2 Total and age-specific rate of ever-partnered women subject to sexual and/or physical violence by current or former intimate partner in the last 12 months by frequency Total and age-specific rate of ever-partnered women subject to sexual and/or physical violence by current or former intimate partner during lifetime by frequency Total and age specific rate of women subjected to psychological violence in the past 12 months by the intimate partner Total and age specific rate of women subjected to economic violence in the past 12 months by the intimate partner Total and age specific rate of women subjected to female genital mutilation

Required classifications for the indicators 1-4: severity (for physical violence) 1-4: relationship to perpetrator 1-6: frequency Denominators 1-4: all women 5-8: ever-partnered

Criteria that were considered for the VAW module Set of indicators should be addressed (as a minimum) Building on instruments that have been well tested and validated across cultures Enabling comparative results (also with surveys already done)

Central project structure [to be completed]

Study design Household survey Study population all women 15+ Not men for safety and practical reasons Representative for whole country Multi-stage sampling scheme Interview one eligible woman per household (randomly selected) [other aspects]

Ethical considerations Sensitivity of research topic The survey uses a “safe name” Individual consent / voluntary participation Confidentiality Physical safety of informants & researchers Do no harm, respect women’s decisions & choices Mechanisms to support researchers & field-workers Avoid harmful publicity Provision of crisis intervention Findings used in advocacy, policy making & intervention

VII. Questionnaire Outline

Structure of VAW module Questions on demographic characteristics of respondent (besides age in particular partnership status and partnership history) Questions on partner violence: psychological, economic, physical, sexual Questions on violence by others since age 15: physical and sexual

SECTION ON VIOLENCE BY PARTNERS

Intimate Partner violence: 2 sets of questions A) Questions for current or most recent partner B) Questions for any other previous partner Acts of controlling behaviour Acts of economic violence Acts of emotional abuse Acts of physical violence Acts of sexual violence

Measurement of controlling behaviour by partner He tries to keep you from seeing your friends? He tries to restrict contact with your family of birth? He insists on knowing where you are at all times? He ignores you and treats you indifferently? He gets angry if you speak with another man? He is often suspicious that you are unfaithful? He expects you to ask his permission before seeking health care for yourself?  

Measurement of economic abuse by partner He refuses to give you enough money for household expenses, even when he has money for other things? [other questions if applicable]  

Measurement of emotional violence by partner Insulted you or made you feel bad about yourself? Belittled or humiliated you in front of other people? Done things to scare or intimidate you on purpose (e.g. by the way he looked at you, by yelling and smashing things)? Verbally threatened to hurt you or someone you care about?

Measurement of physical violence by partner Slapped or threw something at that could hurt you? Pushed or shoved you or pulled your hair? Hit with his fist or with anything else that could hurt you? Kicked, dragged or beat you up? Choked or burnt you on purpose? Threatened with or actually used a gun, knife or other weapon against you? Moderate Severe

Measurement of sexual violence by partner Were you ever forced to have sexual intercourse when you did not want to? Did you ever have sexual intercourse you did not want because you were afraid of what he might do? Ever force you to do something sexual that you did not want or that you found degrading or humiliating?

Reference period For each of the acts of abuse or violence: controlling behaviours, economic, emotional, physical and sexual violence: past 12 months lifetime

Frequency For acts of emotional, physical and sexual violence, and for both past 12 months and before past 12 months: Once, few, many times In test module for events of physical and sexual violence in the past 12 months: 1) daily, weekly, monthly, less than 1/month 2) estimated absolute count

Severity For physical partner violence and sexual partner violence: nature of act Injuries as direct effect of any physical or sexual violence (asking for specific injuries) Miscarriage as direct effect Self reported impact on physical or mental wellbeing Are you ever afraid of partner (never, sometimes, many times, all the time)

Type of partner relationship Partner violence questions are separately asked for current or most recent partner any previous partner(s) Type of relationship with partner (married, living together, dating) is collected for the previous partners who were violent for each set of controlling behaviours, emotional, physical and sexual violence

Non reporting of violence One question at the end -- referring to any type of partner violence reported: “Who have you told about your (previous) partner’s behaviour?” (pre-coded list)

SECTION ON VIOLENCE BY OTHERS THAN PARTNERS

Measurement of physical violence by others than partners Since the age of 15, has anyone ever hit, beaten, kicked or done anything else to hurt you physically? Threw something at you? Pushed you or pulled your hair? Choked or burnt you on purpose? Threatened with or actually used a gun, knife or other weapon against you? PROBE: Anyone else? How about a relative? How about someone at school or work? How about a friend or neighbour? A stranger or anyone else?

Perpetrators, reference period and severity Pre-coded list of perpetrators For each of the perpetrators mentioned: How many times did this happen since you were 15 y: once, few, many How many times did this happen in the past 12 months: once, few, many For the each of (max 3) most serious perpetrators: 3 questions on injuries

1. Measurement of sexual violence by others than partners – Rape Since the age of 15, has anyone ever forced you into sexual intercourse when you did not want to for example by threatening you, holding you down or putting you in a situation that you could not say no. Remember to include people you have known as well as strangers. Please at this point exclude attempts to force you. Who did this to you? (followed by probes)

2. Measurement of other forms of sexual violence by others Since the age of 15, has anyone attempted to force you into a sexual act you did not want, attempted to force you into sexual intercourse (which did not take place), touched you sexually, or did anything else sexually that you did not want. Remember to include people you have known as well as strangers. Who did this to you? (followed by probes)

Perpetrators and reference period sexual violence (both sets) Pre-coded list of perpetrators For each of the perpetrators mentioned: How many times did this happen since you were 15: once , few, many How many times did this happen in the past 12 months: once, few, many

VI. Interviewing Techniques

Introducing the study: Dress appropriately Make a good first impression Have a positive approach Stress confidentiality Answer questions frankly Interview the respondent alone

Conducting the interview: Be neutral Never suggest answers Do no change the wording or sequence of questions Use tact with hesitant respondents Do not judge the woman Do not skip questions Do not hurry the interview Do not show questionnaire to anyone!

Questionnaire format principles Lower cast  should be read out CAPITALS  should NOT be read out Numerical response codes(1, 2, 3,...) : only one response allowed Alphabetical response codes (A, B, C...): more than one response is allowed Questions should be asked as written Always put a mark for a question asked Follow skip patterns exactly

Accompanying materials Question by question explanation of the questionnaire Interviewer manual [birth dates table] [Dummy questionnaire] [Supervisor manual] Code book, analysis plan

Field Procedures Preparatory activities Contacting households What is a household? In this study: (1) usually living and eating together [(2) visitors staying last 4 weeks] [(3) domestic workers 5 nights/week] Locating sample households

Problems in contacting households Selected household moved, dwelling is vacant Selected household moved, new household in dwelling Dwelling number and name of head of household do not match reality in field Selected household does not live in the listed structure

Problems (continued) Listing shows one household in dwelling, but two are living there. The head of household has changed House is closed and family is away temporarily (a few weeks) House is closed and no one lives there House is closed, family is out for the day

Introducing the study “A survey on [use the safe name]” Do not mention domestic violence in initial contact

Problems contacting selected women Selected woman not available Respondent refuses to be interviewed Interview not completed Respondent incapacitated Revisiting households

Informed consent Confidentiality of study General purpose of study Some topics may be difficult to discuss Respondent may skip any question or stop the interview at any point [Signature of interviewer]

Asking questions Read exactly as written Do not suggest one response over another Read questions in the order indicated Follow instructions on how to read questions Do not emphasize one response choice over another

More tips for asking questions Probing For correctness For clarity Completeness Don’t skip questions when not required “Don’t know” Refusal to answer a question Do not let woman read the questions Follow skips and filters

Recording the responses Pre-coded responses One response possible Multiple responses possible

Safety and ethical issues Sensitivity of research topic Individual consent and voluntary participation Confidentiality Physical safety of respondent Respecting women’s decisions (Child abuse reporting) Provision of crisis intervention

Supporting women reporting violence Your role as an interviewer is: To record women’s responses to questions Not to provide counseling or advice

Supporting women reporting violence Responding to women becoming distressed Take time to talk with kindness and sensitivity Be patient and composed Sympathetic comments, such as “I know this is difficult” Offer tissue Offer to take a break or finish interview later

Supporting women reporting violence Only terminate the interview: if woman states that she does not want to continue If you feel that it would be highly detrimental to continue

Supporting women reporting violence Handling interruptions Explore ways to obtain privacy Re-schedule remaining section of interview Turn to “dummy” questions

“. I hardly could pull myself together not to cry “... I hardly could pull myself together not to cry. I wanted to get out of the house as soon as possible and cry out loud.... I hardly made it to the car; as soon as I told my whole team they all burst out in tears. The most painful thing for me was not being able to do anything. At the end I thought that this very research is about hope, and I have done my part.” (interviewer in Turkey)

Support for interviewers Debriefing sessions with supervisors Talk to supervisor or other members of the team Ask for counseling

Safety for interviewers Locating a respondent in the evening Approaching a respondent Interruptions during interview Other precautions Work as a team

“Maybe I was mediating by listening to her for half an hour, and it was worth the world when at the end she thanks me and tells me she felt worthy.” (interviewer in Turkey)

Module and trainings materials developed by Henrica (Henriette) Jansen (c) photos: Henrica Jansen