DOMESTIC VIOLENCE:

THE MEASURED AND THE TO BE

MEASURED
Sunita Kishor (Ph.D.)
Demographic and Health Research
Macro International, Inc.
Maryland, USA

Overview
What we know
.and the data with which we know it (DHS
examples)
Lessons learned
.and the questions raised
What we do not know

What is the DHS?
Nationally-representative household surveys with
large samples (typically 6000 +; India-100,000+)
Usually done every 5-7 years
Provide indicators for monitoring at the national and
sometimes, sub-national level
Comparable across countries and over time
Includes information in selected countries on
domestic violence (27) and violence against men
Violence measurement in the DHS yields
information on: prevalence, risk factors, and
consequences of violence.
Defining what violence to measure
Ensuring validity of the measures:
the how
Ensuring safety and ethical
standards
Determining what else to measure
other than prevalence
Measurement Challenges
History of violence measurement in the
DHS
Earliest efforts:
Country-specific questions (Colombia 1990 & 1995)
Questions developed and implemented as part of topic-
specific studies
1993 Philippines Safe Motherhood Study
1995/96 Uganda Negotiating Reproductive Outcomes Study.
1995 Egypt DHS as part of the womens status module

Special efforts were made in the 1998 Nicaragua DHS
develop questions that increased the validity of the DV
measure

The current module
incorporates lessons from the Egypt and Nicaragua exercises
accompanied by guidelines adapted from WHO guidelines on
its ethical implementation
Validity of Data
No catch-all term to capture violence
Recommendation: Ask about different
types of violent acts separately,
specifically, as in the Conflict Tactics
Scale (CTS)

Risk of underreporting of violence
Recommendations: Build rapport,
ensure privacy, provide multiple
opportunities to reveal abuse
Forms of Spousal Violence: Definitions
Physical violence Any of the following acts of
violence perpetrated by her husband:

Pushed her, shook her, or threw something at
her
Slapped her
Twisted her arm or pulled her hair
Punched her
Kicked her, dragged her, or beat her up
Tried to choke her or burn her on purpose
Threatened her or attacked her with a weapon
Forms of Spousal Violence: Definitions
Sexual violence: Any of the following:

Forced her to have sexual intercourse when she
did not want to
Forced her to perform sexual acts she did not
want to

Emotional violence: Any of the following:
Said or did something to humiliate her in front of
others
Threatened to hurt or harm her or someone close
to her
Insulted her to made her feel bad about herself
Violence by Others

Physical violence by others
From the time you were 15 years old has anyone (other
than your current/last husband) hit, slapped, kicked, or
done anything to hurt you physically? (Who?)
Can include ex-husbands
Violence during pregnancy also uses similar question
(Who?)
Can include current husbands

Sexual violence at any time in life
At any time in your life, as a child or as an adult, has
anyone ever forced you in any way to have sexual
intercourse or perform any other sexual acts? (Who and
Age at first occurrence determined)
Can include current husbands
Other Issues Examined


Timing of initiation of spousal violence

Injuries related to spousal violence

Wives initiating spousal violence

Data on known or potential correlates

Help seeking by abused women
DHS domestic violence data in 27
countries
Africa
Cameroon 2004
DRC 2007*
Egypt 1995 & 2005
Kenya 2003
Liberia 2006/07*
Malawi 2004
Mali 2006*
Namibia 2006*
Rwanda 2005
South Africa 1998
Uganda 2006
Zambia 2001/02
Zimbabwe 2005/06*

Asia/South Asia
Bangladesh 2004
Cambodia 2000 & 2005
India 1998/99 & 2005/06
Latin America/Caribbean
Bolivia 2003
Colombia 1990, 1995, 2000, 2005
Dominican Republic 2002 & 2007*
Haiti 2000 & 2005
Honduras 2005
Nicaragua1997/98
Peru 2000 & 2004



Eurasia
Azerbaijan 2006*
Moldova 2005
Turkmenistan 2001*
Ukraine 2007*

* Data not yet available.
Spousal Violence: India 2005-06
37
35
10
16
27
24
21
7
11
40
Physical, sexual,
or emotional
violence
Physical or
sexual violence
Physical
violence
Sexual violence Emotional
violence
Ever
In the past 12 months
Percent of ever-married women age 15-49
Only 1% of married women
have ever initiated violence
against their husbands.
At what marital duration does spousal
violence first occur?
87% of spousal
violence initiated
within 5 years of
marriage
0
37 35
32
7
13
0%
20%
40%
60%
80%
100%
Marriage <1 year Within 2
years
Within 5
years
Within 10
years
More than 10
years
Not experienced violence
Experienced violence
87% of spousal
violence initiated
within 5 years of
marriage
Percent
0
37 35
32
7
13
0%
20%
40%
60%
80%
100%
Marriage <1 year Within 2
years
Within 5
years
Within 10
years
More than 10
years
Not experienced violence
Experienced violence
87% of spousal
violence initiated
within 5 years of
marriage
India 2005-06
Education and Spousal Violence:
India 2005-06
Percent of ever-married women
46
12
47
21
No education 12+ years of
education
Women's education
Husband's education
48
36
32
23
Neither
educated
Husband
better
educated
Wife
better
educated
Both
equally
educated
Spousal education difference
What other factors are strongly associated
with the likelihood of spousal violence?
49
47
30
69
Yes
No
RESPONDENT'S FATHER BEAT
HER MOTHER
Gets drunk very often
Gets drunk sometimes
Drinks, does not get drunk
Never drinks
HUSBAND'S ALCOHOL
CONSUMPTION
Percent of ever-married women
India 2005-06
What other factors are strongly associated
with the likelihood of spousal violence?
60
30
49
47
30
69
Yes
No
RESPONDENT'S FATHER BEAT
HER MOTHER
Gets drunk very often
Gets drunk sometimes
Drinks, does not get drunk
Never drinks
HUSBAND'S ALCOHOL
CONSUMPTION
Percent of ever-married women
India 2005-06
Injuries Due to Spousal Violence
38
36
9
7
2
Any of these injuries
Cuts, bruises, or aches
Eye injuries, sprains,
dislocations, or burns
Wounds, broken bones/teeth,
other serious injury
Severe burns
Percent of women who have experienced spousal
violence who had:
India 2005-06
What we do know
Spousal violence varies from about 14% in Cambodia
to 59% in Uganda
Typically, half or more of the women who have ever
experienced spousal violence have experienced it in the past
12 months
Spousal sexual violence experienced by 5-20%
Physical violence most common form of violence
Violence begins early in marriage
Violence results in injuries
Violence varies by education and wealth and has
intergenerational effects
However, not explained by alcohol or parental effects
Further analysis of the data show that there are strong
links to health outcomes for mothers and their children
Questions Arising from Lessons Learned


How do we measure trends?

Men, the CTS, and measurement of
violence against women

Should we be moving from
measuring prevalence to measuring
incidence?
Prevalence of Spousal Violence: Uganda
2006
59
36
48
49
24
7
20
35
Any physical
or sexual
violence
Sexual
violence
Physical
violence
Emotional
violence
Women Men


Percent age 15-49
Consequences and Help Seeking:
Uganda 2006
Percent of ever-married women/men who have experienced violence:
37 37
24
26
Ever Past 12 months
Women Men
31
12
48
35
34
14
41
34
Physical
only
Sexual
only
Physical
and
sexual
Any
violence
Women Men
who report injuries who sought
help
Men, the CTS, and measures of VAW
Question raised:
Are the instruments not able to distinguish the
syndrome of violence against women from common
couple violence?
Answering this question is a challenge and in turn raises
the following questions about measuring and defining
violence:

Is it important who initiates the violence?
Should factors such as helplessness and fear be considered?
Should the violent acts be made more specific?
Should frequency be taken into account?
Should the definition of violence be any act from the list or a
clustering of acts?
For M &E: Prevalence or Incidence?
Advantages Disadvantages
Prevalence
Def: Old + New
cases ever or in a
time period

Already have measures
Known to affect health
Provides larger #s of cases
for analysis
Can measure change over
longer periods of time
Great for national level
monitoring
Easy to understand
Tends to be static over the
short period
Largely descriptive
Not good for evaluation and
impact assessment
Not useful for criminalizing
violence

Incidence
Def: New cases in
a time period

Good for criminalizing
violence
Good for impact
assessment
May distinguish better
between VAW and
common couple violence
Not used much in surveys
May not be useful for long
term monitoring
May not yield enough cases
for analysis
Not likely to be stable across
surveys and hence difficult
to compare

sunita.kishor@macrointernational.com

Photo credits: Photos courtesy of M/MC Photoshare at jhuccp.org/mmc
For Specific Questions:
measuredhs.com