Reproduction, Functional Autonomy and Changing Experiences of Intimate Partner Violence Within Marriage in Rural India
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Reproduction, Functional Autonomy and Changing Experiences of Intimate Partner Violence Within Marriage in Rural India CONTEXT: The literature on intimate partner violence in resource-poor contexts relies primarily on cross-sectional By Christine Bourey, studies. Because changes in women’s status and empowerment are hypothesized to influence violence vulnerabil- Rob Stephenson ity, longitudinal studies are needed to determine the potential benefits and harms associated with such changes. and Michelle J. Hindin METHODS: Data were collected prospectively from a representative cohort of 4,749 married women in rural areas of four socially and demographically diverse states in India in 1998–1999 and 2002–2003. A multinomial regression model including social and demographic characteristics and intersurvey changes and events related Christine Bourey is a master’s candidate, to functional autonomy and reproduction was fitted to a categorical outcome measuring the absence (reference), and Rob Stephenson initiation, cessation and continuation of intimate partner violence. is associate professor, both in the Hubert RESULTS: Continued freedom of movement, increased freedom of movement and continued financial autonomy Department of Global between baseline and follow-up were associated with a lower risk of violence initiation rather than no violence Health, Rollins School of Public Health, (relative risk ratio, 0.7 for each). Having a first child was associated with lower risk of violence initiation and con- Emory University, tinuation rather than no violence (0.6 and 0.2, respectively). Women who reported that their relative economic Atlanta, GA, USA. contribution to the household decreased or increased and women who experienced an unwanted pregnancy had Michelle Hindin is a higher risk of violence continuation rather than no violence (1.8, 1.8 and 1.5, respectively). The death of a child associate professor, was associated with higher risk of violence initiation rather than no violence (1.4). Department of Popu- lation, Family and Reproductive Health, CONCLUSION: Future research to inform interventions to reduce intimate partner violence should consider how Bloomberg School changes in women’s reproductive experiences and functional autonomy may be linked to changes in intimate of Public Health, partner violence. The Johns Hopkins International Perspectives on Sexual and Reproductive Health, 2013, 39(4):215–226, doi: 10.1363/3921513 University, Baltimore, MD, USA. Male-perpetrated intimate partner violence is the most com- ic worth of women, dowries that increase the economic mon form of violence against women,1,2 and its prevalence burden of girls,25 and dependence on sons in old age and in South Asia is among the highest in the world.3,4 In India, death,23 married women face pressure to prove their value 34% of women of reproductive age reported ever having and social worth through reproduction, and the produc- experienced intimate partner violence;5 this violence has tion of sons in particular.24 serious health consequences for both women and children, Intimate partner violence is frequently viewed as a cul- including poor nutritional status,6,7 decreased mental8–10 turally acceptable form of punishment and appropriate and reproductive health,11–13 increased maternal and child demonstration of masculinity. Although extreme physical mortality,14,15 and limited health seeking.16–18 violence is proscribed,26 control, psychological abuse, ne- Intimate partner violence in India occurs within the glect and isolation have become normalized.27 Acceptance context of entrenched gender inequality. Preference for of violence is prevalent among both men and women. In male children has led to sex-selective abortion, female India, 51% of men and 54% of women agree that a hus- infanticide, and neglect and abandonment of female chil- band is justified in beating his wife in at least one of the dren;19 between 1950 and 2012, there were an estimated following circumstances: if she goes out without telling 58.9 million “missing” girls.20 Gender discrimination dur- him, if she neglects the house or children, if she argues ing childhood results in differential allocation of nutrition, with him, if she refuses to have sex with him, if she does education and medical care,21–23 which reflects the deval- not cook food properly, if he suspects her of being unfaith- ued place of females in society. Nearly half (47%) of all ful or if she shows disrespect for her in-laws.5 Although women aged 20–24 were married before the legal age of there is a clear association between violence, masculinity 18,5 and as women move from their natal homes to share and youth, and the proportion of men who justify violence a home with their husband, his parents and his unmarried decreases with age,5 justification increases with age among siblings, the protection provided by familial and communi- women, suggesting that women may be socialized to ac- ty support networks is disrupted.24 Because of patrilineal cept and rationalize intimate partner violence. inheritance practices that diminish the social and econom- India has received special attention within the growing Volume 39, Number 4, December 2013 215 Changing Experiences of Intimate Partner Violence in Rural India TABLE 1. Percentage distribution of rural married women aged 15–39, by changes in intimate partner violence, according to selected social and demographic characteristics, Bihar, Jharkhand, Maharashtra and Tamil Nadu, India, 1998–1999 and 2002–2003 Characteristic All None Initiation Cessation Continuation Total (N=4,749) (N=3,379) (N=781) (N=271) (N=318) State*** Bihar 40.2 71.5 15.8 6.1 6.6 100.0 Jharkhand 13.9 69.2 21.0 3.3 6.5 100.0 Maharashtra 17.9 85.9 9.1 2.2 2.8 100.0 Tamil Nadu 28.1 62.3 19.8 8.5 9.4 100.0 Religion Hindu 88.2 70.7 16.4 6.0 6.9 100.0 Muslim 8.8 73.8 16.7 4.1 5.5 100.0 Other 3.0 77.5 16.9 2.1 3.5 100.0 Caste*** General caste 18.8 85.8 8.3 2.6 3.4 100.0 Scheduled caste/tribe 28.8 62.4 20.2 7.4 10.0 100.0 Other backward caste 52.4 70.7 17.3 5.9 6.1 100.0 Age at baseline*** 15–19 12.9 71.5 21.2 2.8 4.6 100.0 20–24 23.4 69.5 18.5 4.5 7.6 100.0 25–29 26.2 69.5 16.8 6.8 7.0 100.0 30–34 20.8 71.2 14.7 6.7 7.4 100.0 35–39 16.7 75.9 11.5 6.8 5.8 100.0 Respondent’s education*** No education 61.7 66.8 18.7 6.5 8.1 100.0 Primary 14.9 72.0 15.8 5.8 6.4 100.0 ≥secondary 23.4 82.2 10.9 3.6 3.3 100.0 Husband’s education*** No education 34.0 63.1 20.4 7.1 9.4 100.0 Primary 19.0 68.8 17.2 5.9 8.2 100.0 ≥secondary 47.0 77.9 13.3 4.7 4.1 100.0 Baseline standard of living*** Low 53.0 64.9 19.6 6.6 8.9 100.0 Medium 38.7 75.4 14.5 5.3 4.8 100.0 High 8.4 91.2 5.5 1.8 1.5 100.0 Head of household*** Husband 68.3 69.0 16.8 6.7 7.5 100.0 Mother-in-law 24.0 75.6 15.6 3.6 5.2 100.0 Other 7.8 76.2 16.0 3.8 4.1 100.0 literature on intimate partner violence in resource-poor ings in India. For example, marital type (arranged or contexts.28 Numerous studies have evaluated demo- love),37 satisfaction with the dowry,37,38 parity,38,39 child- graphic and social variables for associations with intimate lessness32,40 and women’s employment41,42 have not been partner violence among representative and nonrepresen- consistently associated with intimate partner violence tative samples. Studies have generally highlighted the sig- across studies. Similarly, one study showed that women’s nificance of individual-level variables (e.g., socioeconomic partial economic contribution to the household was asso- status,29 education30 and marital age29) and selected expe- ciated with greater odds of violence;40 however, another riences (e.g., spousal alcohol use,31 extramarital sex32 and study found that full responsibility for meeting house- witnessing violence in childhood32), although experiences hold expenses was linked to increased odds, but shared and attitudes related to gender have also been considered. responsibility was associated with decreased odds of In particular, because gender inequality (seen in house- violence.43 Further, a study of decision-making autonomy hold power dynamics and community norms) is thought and freedom of movement found that only selected mea- to influence women’s vulnerability to intimate partner sures, such as household wealth, tolerance of violence and violence, attention increasingly has been granted to asso- decision-making autonomy, were associated with past-year ciations between women’s status and empowerment and intimate partner violence and that status inconsistencies, intimate partner violence.33–36 such as differences in spousal age and education, were not Studies investigating the associations between gender- associated with intimate partner violence.44 related experiences at the individual- or household-level Although measures of status and empowerment are and intimate partner violence have revealed mixed find- hypothesized to be associated with intimate partner vio- 216 International Perspectives on Sexual and Reproductive Health TABLE 1. continued Characteristic All None Initiation Cessation Continuation Total (N=4,749) (N=3,379) (N=781) (N=271) (N=318) Baseline marital duration*** 0–4 years 24.1 72.4 19.9 3.2 4.5 100.0 5–9 years 23.4 67.2 18.7 5.9 8.2 100.0 ≥10 years 52.5 72.3 13.9 6.7 7.1 100.0 Age at start of current union 12–14 23.7 69.3 16.5 6.6 7.7 100.0 15–17 43.0 70.8 16.9 5.2 7.1 100.0 ≥18 33.3 73.0 15.8 5.8 5.5 100.0 Spousal age difference Wife older or husband 0–4 years older 35.5 70.6 16.7 5.0 7.6 100.0 Husband 5–9 years older 45.4 70.7 16.5 6.4 6.5 100.0 Husband ≥10 years older 19.0 73.2 16.0 5.4 5.4 100.0 Husband’s reaction to dowry*** Unsatisfied 4.0 45.0 29.1 7.9 18.0 100.0 Neutral/unsure 12.5 69.6 15.5 7.6 7.3 100.0 Satisfied 76.3 73.2 15.8 5.2 5.8 100.0 No dowry 7.3 66.6 18.2 6.6 8.7 100.0 Baseline parity*** 0 12.9 72.3 20.6 2.6 4.4 100.0 1 15.9 67.1 21.0 4.6 7.3 100.0 2 20.9 70.9 16.4 6.5 6.3 100.0 3 20.9 71.8 14.0 6.2 8.1 100.0 ≥4 29.5 72.6 13.9 6.8 6.7 100.0 Witnessed intimate partner violence in childhood*** Yes 23.8 54.8 26.0 7.3 12.0 100.0 No 76.2 76.3 13.5 5.2 5.0 100.0 Experienced non–intimate partner violence since age 15*** Yes 4.4 40.8 22.3 17.1 19.9 100.0 No 95.6 72.6 16.1 5.2 6.1 100.0 ***p<.001.