1. |
- Chalise, P., et al.
(author)
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Addressing Domestic Violence in Antenatal Care Environments in Nepal (ADVANCE) - study protocol for a randomized controlled trial evaluating a video intervention on domestic violence among pregnant women
- 2023
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In: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
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Journal article (peer-reviewed)abstract
- BackgroundDomestic violence (DV) prior to, and during pregnancy is associated with increased risks for morbidity and mortality. As pregnant women routinely attend antenatal care this environment can be used to offer support to women experiencing DV. We have developed a video intervention that focuses on the use of behavioral coping strategies, particularly regarding disclosure of DV experiences. The effectiveness of this intervention will be evaluated through a randomized controlled trial (RCT) and a concurrent process evaluation.MethodsAll pregnant women between 12-22 weeks of gestation attending routine antenatal care at two tertiary level hospitals in Nepal are invited to participate. DV is measured using the Nepalese version of the Abuse Assessment Screen (N-AAS). Additionally, we measure participants' mental health, use of coping strategies, physical activity, and food security through a Color-coded Audio Computer Assisted Self Interview (C-ACASI). Irrespective of DV status, women are randomized into the intervention or control arm using a computer-generated randomization program. The intervention arm views a short video providing information on DV, safety improving actions women can take with an emphasis on disclosing the violence to a trusted person along with utilizing helplines available in Nepal. The control group watches a video on maintaining a healthy pregnancy and when to seek healthcare. The primary outcome is the proportion of women disclosing their DV status to someone. Secondary outcomes are symptoms of anxiety and depression, coping strategies, the use of safety measures and attitudes towards acceptance of abuse. Follow-up is conducted after 32 weeks of gestation, where both the intervention and control group participants view the intervention video after completing the follow-up questionnaire. Additionally, a mixed methods process evaluation of the intervention will be carried out to explore factors influencing the acceptability of the intervention and the disclosure of DV, including a review of project documents, individual interviews, and focus group discussions with members of the research team, healthcare providers, and participants.DiscussionThis study will provide evidence on whether pregnant women attending regular antenatal visits can enhance their safety by disclosing their experiences of violence to a trusted person after receiving a video intervention.Trial registrationThe study is registered in ClinicalTrial.gov with identifier NCT05199935.
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2. |
- Rask, Marie, 1974-, et al.
(author)
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Women with abnormal Pap smear result: : a qualitative study of Swedish healthcare professionals' experiences
- 2016
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In: European Journal of Cancer Care. - : John Wiley & Sons. - 0961-5423 .- 1365-2354. ; 25:6, s. 980-991
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Journal article (peer-reviewed)abstract
- A Papanicolaou (Pap) smear can be used to detect pre-cancerous cellular changes, so that they can be treated before they develop into cervical cancer. When the results of a Pap smear test are abnormal, women need further investigation, treatment and follow-up. Healthcare professionals (HCPs) are in a position to care for these women with abnormalities. The aim of this study was to explore the experiences of HCPs in caring for women with abnormal Pap smear results. In total, 20 HCPs from two counties in south-eastern Sweden participated in individual interviews, based on two open-ended questions. Interviews were recorded, transcribed verbatim and analysed using content analysis. The results showed that HCPs experienced that abnormal Pap smear results created anxiety in women, who often sought information from the Internet as a way to cope. Furthermore, the HCPs thought that it was a problem that women chose not to attend investigation, treatment and follow-ups. However, information about the seriousness of abnormal Pap smear results causes women to participate. It is a challenge for HCPs to inform in a reassuring manner. Finally, HCPs should collaborate with women to meet their information needs and to also provide support regarding finding and filtering reliable information on the Internet.
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3. |
- Wijma, Barbro, 1944-, et al.
(author)
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Emotional, physical, and sexual abuse in patients visiting gynaecology clinics : a Nordic cross-sectional study
- 2003
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In: The Lancet. - 0140-6736 .- 1474-547X. ; 361:9375, s. 2107-2113
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Journal article (peer-reviewed)abstract
- BackgroundAbuse against women causes much suffering for individuals and is a major concern for society. We aimed to estimate the prevalence of three types of abuse in patients visiting gynaecology clinics in five Nordic countries, and to assess the frequency with which gynaecologists identify abuse victims.MethodsWe did a cross-sectional, multicentre study of women attending five departments of gynaecology in Denmark, Finland, Iceland, Norway, and Sweden. We recruited 4729 patients; 3641 (77%) responded and were included in the study. Participants completed a postal questionnaire (norvold abuse questionnaire) confidentially. Primary outcome measures were prevalences of emotional, physical, and sexual abuse, and whether abused patients had told their gynaecologist about these experiences. We assessed differences between countries with Pearson's χ2 test.FindingsThe ranges across the five countries of lifetime prevalence were 38–66% for physical abuse, 19–37% for emotional abuse, and 17–33% for sexual abuse. Not all abused women reported current ill-effects from the abusive experience. Most women (92–98%) had not talked to their gynaecologist about their experiences of abuse at their latest clinic visit.InterpretationDespite prevalences of emotional, physical, and sexual abuse being high in patients visiting gynaecology clinics in the Nordic countries, most victims of abuse are not identified by their gynaecologists. This lack of discussion might increase the risk of abused patients not being treated according to their needs. Gynaecologists should always consider asking their patients about abuse.
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4. |
- Dahal, Pranab, et al.
(author)
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The prevalence of gender inequalities and violence in the Eastern Nepal
- 2019
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In: Kathmandu University Medical Journal. - : Kathmandu University. - 1812-2027 .- 1812-2078. ; 17:68, s. 298-305
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Journal article (peer-reviewed)abstract
- Background Gender inequality and gender based violence is more established in societies with stratification and stronger gender norms. Objective To determine prevalence of gender violence, perception on gender issues and awareness on sexual trafficking and rights among men and women in Morang district of Nepal. Method This cross sectional study was conducted among 810 men and 1190 women in twenty different VDCs of Morang district using self-administered computer based self-interview methods during October-November 2016. Result Male in comparison to female reported more physical abuse during their lifetime. Females (n=259, 21.7%) reported more severe lifetime emotional abuse (n=148, 18.2%) compared to the males. Lifetime severe sexual abuse was reported by a close to five percent (n=95) of both sexes. The severe forms of partner violence include choking, threat or use of weapon and setting on fire was identified to be perpetrated by both the sexes. More than 50% (n=1095) of the respondents had known someone using physical violence against their partner in the community. The involvement of female in key economic decision-making was reported by less than 12%. Nearly 72% (n=1441) were aware of occurrence of sexual trafficking from Nepal while only 46% (n=918) were aware of sexual trafficking occurring from their vicinity. Conclusion The study confirms that despite awareness on gender equality and sexual trafficking, the prevalence of violence and adherence to stronger gender stereotypes, stigmas and roles indicates much need of awareness for establishing equalities and reducing gender violence. © 2019, Kathmandu University. All rights reserved.
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5. |
- Karim, K.M. Rabiul, et al.
(author)
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Development of the Social Acceptance of Wife Abuse Scale in Rural Bangladesh
- 2021
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In: Partner Abuse. - : Springer. - 1946-6560 .- 1946-6579. ; 12:1, s. 21-41
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Journal article (peer-reviewed)abstract
- This study aimed to develop and validate the Social Acceptance of Wife Abuse Scale (SAWAS) in a Bangladeshi context. A total of 18 initial items were generated through literature review and focus group interviews with 16 university students. After meetings with 3 experts and 4 research students having extensive fieldwork experiences on domestic violence issues in rural Bangladesh, 12 items remained. These 12 items were subjected to exploratory factor analysis (EFA) with a sample of 186 university students. This produced a 2-factor, 6-item scale. We labeled the two factors, the circumstances where wife abuse is socially accepted: “disobeying family obligations” and “challenging male-authority.” Using a confirmatory factor analysis (CFA), the factor solution was further tested with another sample of 1,929 rural citizens. The SAWAS showed very good internal consistency and validity. The SAWAS can serve as a protocol to direct measures in the effective prevention of widespread wife abuse in Bangladesh.
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6. |
- Karim, K.M. Rabiul, et al.
(author)
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Differences in the acceptance of wife abuse among ethnic minority Garo and Santal and mainstream Bengali communities in rural Bangladesh
- 2020
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 15:7, s. 1-19
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Journal article (peer-reviewed)abstract
- Studies on wife abuse in Bangladesh predominantly include the mainstreamBengalipopulation, although there are at least 27 ethnic minority communities including a few 'female-centered' matrilineal groups living in the country. This study explored ethnic differences in the attitudinal acceptance of wife abuse among matrilineal ethnic minorityGaro, patrilineal ethnic minoritySantal, and mainstream patriarchalBengalicommunities in rural Bangladesh. Adopting a cross-sectional design, the study included 1,929 women and men randomly selected from 24Garo,Santal, andBengalivillages. Multivariate Poisson regression was performed to predict the number of contextual events, where the respondents attitudinally endorsed wife abuse. Of the sample, 33.2% were fromGaro, 33.2% fromSantal, and 33.6% from theBengalicommunities. The acceptance of wife abuse was high in the sample; specifically, 34.1% of the respondents accepted physical wife abuse, 67.5% accepted emotional abuse, and 71.6% accepted any abuse (either physical or emotional) at least on one contextual reason provided in a 10-item scale. The mean for accepting any abuse was 3.0 (SD= 2.8), emotional abuse 2.3 (SD= 2.2), and physical abuse 0.8 (SD= 1.4). The study showed that the rates of accepting any abuse and physical abuse were respectively 16% and 56% lower amongGaroas well as 14% and 33% lower amongSantalthan that of theBengalicommunity. Data also revealed that individual level factors like younger age, higher education, prestigious occupation as well as family level factors such as higher income, female mobility, and female family authority were inversely associated with the acceptance of wife abuse in the sample. It appears that the gender regime of a society has a great influence on the attitudes toward wife abuse. We argue that a comprehensive socio-cultural transformation of the patriarchal societies into a gender equal order is imperative for the prevention of widespread wife abuse in the country.
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7. |
- Karim, K.M. Rabiul, et al.
(author)
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Does Childhood Experience of Family Victimization influence Adulthood Refusal of Wife Abuse? Evidence from Rural Bangladesh.
- 2021
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:6
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Journal article (peer-reviewed)abstract
- This study examined how different forms of childhood family victimization are associated with the attitudinal (not actual action) refusal of wife abuse among women and men in rural Bangladesh. It included 1,929 randomly selected married women and men. Of the sample, 31.3% (Men = 49.3%, Women = 13.5%) attitudinally refused overall wife abuse, 38.5% (Men = 53.2%, Women = 23.8%) refused emotional abuse, 67.0% (Men = 82.5%, Women = 51.6%) refused physical abuse, 78.0% (Men = 88.6%, Women = 67.4%) refused abuse on wife’s disobeying family obligations, and 32.3% (Men = 50.3%, Women = 14.6%) refused abuse on challenging male authority. Multivariate logistic regression revealed that the odds ratio (ORs) of the attitudinal refusal of overall wife abuse were 1.75 (p = .041) for the childhood non-victims of emotional abuse and 2.31 (p < .001) for the victims of mild emotional abuse, compared to the victims of severe emotional abuse. On the other hand, the ORs of the overall refusal of abuse were 1.84 (p = .031) for the non-victims of physical abuse and 1.29 (p = .465) for the victims of mild physical abuse, compared to the childhood victims of severe physical abuse. Data further revealed that the childhood non-victimization of physical abuse increased all types of attitudinal refusal of wife abuse, e.g., emotional abuse, physical abuse, abuse on disobeying family obligations, and abuse on challenging male authority. Compared to the childhood experiences of severe emotional abuse, data also indicated that childhood exposure to mild emotional abuse might increase the attitudinal refusal of wife abuse on a few issues, e.g., abuse on disobeying family obligations, abuse on challenging male authority, and physical abuse. It appeared that childhood experiences of family victimization greatly influence different types of attitudinal refusal of wife abuse. We argue that the issue of childhood victimization should be brought to the forefront in the discourse. We recommend that state machinery and social welfare agencies should expend significant efforts to stop child abuse within the family and in other areas of society in rural Bangladesh.
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8. |
- Karim, K.M. Rabiul, et al.
(author)
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Does female authority prevent male marital violence? : Evidence from rural Bangladesh
- 2021
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In: Journal of Interpersonal Violence. - : Sage Publications. - 0886-2605 .- 1552-6518. ; 36:11-12, s. 5055-5074
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Journal article (peer-reviewed)abstract
- While relative resource status between husband and wife is widely discussed in the explanation of male marital violence (MMV) behaviors, the influence of relative family authority between husband and wife on the violence has been generally overlooked in previous studies. An examination can provide a better understanding of the issue. This study examined how various levels of female authority within the family are associated with MMV against women in rural Bangladesh. The study adopted a cross-sectional design and included 342 married men randomly selected from five northwest villages. Negative binomial regression was performed to predict the frequency of self-reported MMV behaviors in a 1-year recall period which estimated the ratios comparing absolute male authority to egalitarian authority within the family. Of the sample, 37.4% were the egalitarian/fair female authority, 41.2% were the higher male authority, and 21.4% were absolute male authority families; 71.1% of the men revealed that they had resorted to at least one incident of MMV (psychological or physical or sexual) against their wives in the year preceding the survey. The mean of yearly MMV occurrences was 6.29 ( SD = 7.58), ranging from 0 to 42. The study revealed that the frequency of MMV against women was 1.96 times higher among absolute male authority families than in egalitarian families. It further revealed that the frequency of psychological abuse was 1.63 times, physical attack 2.89 times, and sexual coercion 1.88 times higher among absolute male authority families than among egalitarian/fair female authority families. Higher male authority did not appear to be different from egalitarian authority in MMV occurrences. The study suggests that increased female authority within the family unit may prevent women from being exposed to MMV in a patriarchal social order.
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9. |
- Karim, K.M. Rabiul, et al.
(author)
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Gender and Awareness of Laws on Intimate Partner Violence : A Study Among Bengali, Garo, and Santal Ethnic Communities in Rural Bangladesh
- 2023
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In: Journal of Interpersonal Violence. - : Sage Publications. - 0886-2605 .- 1552-6518. ; 38:1-2, s. 6013-645
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Journal article (peer-reviewed)abstract
- Previous studies on intimate partner violence (IPV) against women in Bangladesh rarely focused on the effectiveness of primary prevention strategies like legal remedies. There is also a lack of studies on the issues among the ethnic minority communities in the country. This study examines the awareness of laws on IPV (such as recognizing the abusive acts and knowing the sanctions) among the ethnic Garo and Santal and mainstream Bengali communities in rural Bangladesh. The study randomly included 1929 married women and men from 24 villages. It appeared that the respondents were not adequately aware of the relevant legal provisions. There were also gender and ethnic differences in the issues. On average, the respondents maintained a low score on recognizing abusive acts. The awareness was further lower among the women compared to the men. In addition, multivariate analysis indicated that the Bengali women had relatively a better understanding of the issues than the Garo and Santal women. However, the Garo men showed poorer awareness of recognizing the abusive acts than the Bengali and Santal men. On the other hand, the respondents also maintained a very insufficient knowledge of the sanctions against such abusive acts, whereas women also showed a lower awareness compared to their male counterparts. Data further revealed that the Santal women had a more inadequate understanding of the issues than the Bengali and Garo women. However, the Garo men had more awareness of the sanctions than the Bengali and Santal men. The study reveals that people are unfamiliar with the laws governing IPV. It shows that understanding legal issues is another field of gender and ethnic inequality in the country. We suggest that there should be intervention to make aware the citizen, mainly women of all ethnicities, to ensure the efficacy of the laws.
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10. |
- Karim, K.M. Rabiul, et al.
(author)
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Gender differences in marital violence : a cross-ethnic study among Bengali, Garo, and Santal communities in rural Bangladesh
- 2021
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:5
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Journal article (peer-reviewed)abstract
- Studies on marital violence (MV) in Bangladesh have primarily focused on the women of the mainstream Bengali people, although half of the population is men, and there are also ethnic minority communities with diverse gender constructions. The current study examined the gender differences in MV among the matrilineal ethnic minority Garo, patrilineal ethnic minority Santal, and the patrilineal mainstream Bengali communities in rural Bangladesh. Adopting a cross-sectional design, we randomly included 1,929 currently married men and women from 24 villages. We used cross-tabulations as well as multivariate logistic regressions to estimate the ethnic and gender differences in MV. Data revealed that women were widely exposed to different types of MV, while only a few men experienced such abuses. It showed that 95.6% of the women experienced emotional abuse, 63.5% physical abuse, 71.4% sexual abuse, and 50.6% poly-victimization, whereas these rates were quite low among the men (emotional = 9.7%, physical = 0.7%, sexual = 0.1%). No men reported poly-victimization. The odds ratio (OR) for emotional, physical, and sexual MV were respectively, 184.44 (95% CI = 93.65−363.24, p<0.001), 449.23 (95% CI = 181.59−1111.35, p<0.001), and 2789.71(95% CI = 381.36−20407.08, p<0.001) for women compared to men. Data further revealed that matrilineal Garo women experienced less MV (emotional = 90.7%, physical = 53.4%, sexual = 64.0%, poly = 38.8%) than the patrilineal Santal (emotional = 99.4%, physical = 67.3%, sexual = 71.3%, poly = 53.9%) and Bengali women (emotional = 96.6%, physical = 69.6%, sexual = 78.8%, poly = 58.9%). Multivariate regressions also showed that the Bengali society perpetrated more physical (OR = 1.90, 95% CI = 1.27−2.85, p = 0.002) and sexual (OR = 2.04, 95% CI = 1.34−3.10, p = 0.001) MV than the Garo society. It appears that MV is largely a gendered issue in the country. Though both women and men can be the victims of MV, the nature/extent of victimization noticeably differs according to the social organization. Matrilineal society appears to be less abusive than the patrilineal one. Interventions aimed to prevent domestic violence in rural Bangladesh should take these findings into account.
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