Domestic violence and consequent health disorders in Indian women Centre for International Health Curtin University Domestic violence and consequent health disorders in Indian women Andreia Schineanu, PhD student Supervisor: Associate Professor Paola Ferroni Associate Supervisor: Dr Jaya Earnest

Introduction DV is part of a pattern of abusive behaviour and control and includes repeated physical assault, ongoing psychological abuse forced sexual intercourse Main causes of DV in India are perceived male superiority, low status of women in society poverty alcohol abuse inadequate dowry presence of in-laws and absence of male child Effects of DV include physical injuries STD’s unwanted pregnancies mental disorders death (homicide or suicide)

Rationale Very little research data on the relationship between DV and mental and emotional health (MEH) in Indian women Research from western countries has shown significant causative relationship between DV and common mental illnesses such as depression, anxiety and post-traumatic stress disorder (PTSD) Underlying causes of MEH problems in victims of violence are DIFFERENT to the causes of MEH in non-abused women.

Objectives To determine the prevalence and incidence rates of DV in an urban population of Indian women To investigate the relationship between DV and mental and emotional health To establish the main socio-cultural factors that contribute to DV To document coping behaviours and patterns To investigate the relationship between MEH and coping behaviour

Methods Non-experimental, cross-sectional, retrospective Sample size of 907 women Participants selected randomly from a Mumbai slum Selected only currently married women Questionnaire gathered data on demographic characteristics, health, social network, stressors and coping mechanisms, levels of autonomy, marital harmony Use of psychometric test to establish levels of depression (GHQ 12) Analysis of quantitative data was facilitated using SPSS

Results - demographics Mean age was 30.2+6.3 years, (35.7+7.4 for men) 53.2% Hindu, 42.2% Buddhist, 4.6% other 1 in 10 illiterate, 32.2% had primary and 45.2% high school Mean age at marriage 19.9+2.8 and married for 10.5+6.6 years Fertility rate was 2.2+1.1 children per woman 43.7% used contraceptive, majority had tubal ligation 26% reported ill health, 1/3 psychosomatic complaints 89.4% use western style health care provider 61.3% had no paid work (children care, husband did not allow) 30.1% are members of mahila mandal (women’s group) 90.6% receive support from mahila mandal 47.4% of respondents were depressed

Experiences of domestic violence Results Experiences of domestic violence 26.4% 20.8% 18.4% 14.6% 7

Factors that contribute to incidences of DV Results Factors that contribute to incidences of DV Lack of education for both men and women Women who are illiterate are over 3 times more likely to experience psychological and physical violence than those who have college education. Women whose husbands are illiterate are twice as likely to experience physical violence than those whose husbands attended high school and 4 times as likely than those whose husbands attended college Lack of social support Women who are not members of a support group are 2.4 times more likely to be abused than women who are members. 8

Factors that contribute to experiences of DV Results Factors that contribute to experiences of DV Autonomy A woman who is solely responsible for decisions regarding her health is 4 times more likely to experience domestic violence than a woman who makes decisions regarding her health jointly with her husband Women who work are 1.4 times more likely to be abused than women who don’t work. 9

Relationship between DV and depression Results Relationship between DV and depression Type of violence Exp (B) 95% CI (Lower – Upper) Any domestic violence 2.985 2.19 – 4.07 Psychological violence 2.289 1.64 – 3.19 Physical violence 2.376 1.67 – 3.37 Sexual violence 5.116 3.29 – 7.95 10

Limitations Cross sectional study Under-reporting of DV Research confined to a limited geographical location

Acknowledgements Many thanks to the following people: All the women who participated in the study Goretti, Rohini, Supriya, Prajakta, Karuna and Meenal from KJ Somaiya Hospital, Mumbai, India Paola, Jaya, Ali and Leanne from CIH Fredrik, Alex, Nicholas and Emilia, my family This project was partly funded by the Mary Walters Bursary, AFUW, WA Inc.