The Maldives Study on Women’s Health and Life Experiences Initial results on prevalence, health outcomes and women’s responses to violence Emma Fulu © Ministry of Gender and Family The Maldives Study on Women’s Health and Life Experiences: Initial Results on Prevalence, Health Outcomes and Women’s Responses to Violence. ISBN 99915-95-01-5 CONTENTS EXECUTIVE SUMMARY ..........................................................................................................................V ORGANIZATION OF THE STUDY................................................................................................................... V PREVALENCE AND PATTERNS OF VIOLENCE ............................................................................................... VI ASSOCIATIONS OF VIOLENCE WITH SPECIFIC HEALTH OUTCOMES............................................................ VIII WOMEN’S COPING STRATEGIES AND USE OF SERVICES .............................................................................. IX IMPACT OF THE TSUNAMI ON VIOLENCE AGAINST WOMEN.......................................................................... X RECOMMENDATIONS .................................................................................................................................. X CHAPTER 1: INTRODUCTION ............................................................................................................... 1 INTERNATIONAL CONVENTIONS AND AGREEMENTS................................................................................... 2 DEFINITIONS............................................................................................................................................... 2 THE CULTURAL CONTEXT OF THE MALDIVES ............................................................................................. 2 VIOLENCE AGAINST WOMEN IN THE MALDIVES.......................................................................................... 6 CHAPTER 2: RESEARCH OBJECTIVES AND QUESTIONNAIRE................................................... 8 OBJECTIVES OF RESEARCH ......................................................................................................................... 8 RESEARCH QUESTIONS ............................................................................................................................... 8 MEASURING VIOLENCE............................................................................................................................. 10 CHAPTER 3: METHODOLOGY ............................................................................................................ 14 FORMATIVE QUALITATIVE RESEARCH....................................................................................................... 14 QUESTIONNAIRE DEVELOPMENT AND TRANSLATION ................................................................................ 15 INTERVIEWER SELECTION AND TRAINING ................................................................................................. 16 SAMPLE DESIGN........................................................................................................................................ 18 SAMPLE REDESIGN.................................................................................................................................... 19 ORGANIZATION OF THE SURVEY AND FIELDWORK PROCEDURES .............................................................. 20 MECHANISM FOR QUALITY CONTROL ....................................................................................................... 21 DATA PROCESSING ................................................................................................................................... 22 ETHICAL AND SAFETY CONSIDERATIONS .................................................................................................. 23 INTERVIEW GUIDELINES ........................................................................................................................... 24 STRENGTHS AND LIMITATIONS OF THE STUDY.......................................................................................... 24 CHAPTER 4: RESPONSE RATE AND SAMPLE DEMOGRAPHIC................................................. 26 RESPONDENT’S SATISFACTION WITH INTERVIEW ...................................................................................... 28 CHARACTERISTICS OF RESPONDENTS........................................................................................................ 29 STATISTICS AND TABLES........................................................................................................................... 31 CHAPTER 5: PREVALENCE OF INTIMATE PARTNER VIOLENCE ........................................... 32 NATIONAL LEVEL PREVALENCE RATES ..................................................................................................... 33 EMOTIONAL ABUSE AND CONTROLLING BEHAVIOUR ................................................................................ 35 OVERLAP OF PHYSICAL AND SEXUAL PARTNER VIOLENCE........................................................................ 37 CURRENT AND LIFETIME PHYSICAL AND/OR SEXUAL VIOLENCE ............................................................... 38 SEVERITY AND FREQUENCY OF PHYSICAL VIOLENCE ................................................................................ 38 DEMOGRAPHIC FACTORS ASSOCIATED WITH INTIMATE PARTNER VIOLENCE. ........................................... 40 SITUATIONS LEADING TO VIOLENCE ......................................................................................................... 42 WOMEN’S ATTITUDES TOWARDS VIOLENCE ............................................................................................. 42 WEIGHTED ANALYSIS ............................................................................................................................... 44 DISCUSSION.............................................................................................................................................. 45 CHAPTER 6: PREVALENCE OF VIOLENCE BY PERPETRATORS OTHER THAN INTIMATE PARTNERS, SINCE AGE 15.................................................................................................................... 48 PERPETRATORS OF NON-PARTNER VIOLENCE............................................................................................ 49 i PARTNER VIOLENCE COMPARED WITH NON-PARTNER VIOLENCE.............................................................. 50 DISCUSSION.............................................................................................................................................. 51 CHAPTER 7: GIRL CHILD SEXUAL ABUSE PRIOR TO AGE 15................................................... 53 PREVALENCE OF GIRL CHILD SEXUAL ABUSE (UNDER AGE 15) ................................................................. 53 PHYSICAL AND SEXUAL ABUSE OF GIRLS UNDER 18 YEARS OF AGE .......................................................... 54 PERPETRATORS OF GIRL CHILD SEXUAL ABUSE......................................................................................... 55 FIRST SEXUAL EXPERIENCE ...................................................................................................................... 56 COMBINING ALL TYPES OF VIOLENCE AGAINST WOMEN TO GET A NATIONAL PREVALENCE RATE............. 57 DISCUSSION.............................................................................................................................................. 58 CHAPTER 8: ASSOCIATIONS BETWEEN VIOLENCE BY INTIMATE PARTNERS AND WOMEN’S PHYSICAL AND MENTAL HEALTH .............................................................................. 59 INJURIES AS A RESULT OF INTIMATE PARTNER VIOLENCE ......................................................................... 61 PARTNER VIOLENCE AND WOMEN’S GENERAL HEALTH ............................................................................ 62 VIOLENCE AND MENTAL HEALTH ............................................................................................................. 64 DISCUSSION.............................................................................................................................................. 66 CHAPTER 9: INTIMATE PARTNER VIOLENCE, WOMEN’S REPRODUCTIVE HEALTH AND THEIR CHILDREN................................................................................................................................... 68 REPRODUCTIVE HEALTH OUTCOMES......................................................................................................... 69 PARITY ..................................................................................................................................................... 70 CONTRACEPTIVE USE................................................................................................................................72 UNPLANNED PREGNANCIES ...................................................................................................................... 73 ANTENATAL AND POST-NATAL CARE........................................................................................................ 74 EFFECTS OF PARTNER VIOLENCE ON CHILDREN ........................................................................................ 75 DISCUSSION.............................................................................................................................................. 78 CHAPTER 10: WOMEN’S COPING