Structural Context and the Role of Positive Deviance From Community Norms in Shaping Risk for Sexual Intimate Partner Violence in 32 Low- and Middle-Income Countries

2020 ◽  
pp. 088626052092750
Author(s):  
Nicholas Metheny ◽  
Rob Stephenson

Community norms provide social scripts and pathways to accruing social capital that can alter a woman’s risk of experiencing sexual intimate partner violence (IPV). These norms are in turn influenced by the structural environment in which they exist. Missing from the literature is an understanding of how an individual’s departure from community norms—positive deviance—influences the risk of sexual IPV and how this effect may vary across structural environments. Demographic and Health Survey data from 32 low- and middle-income countries (LMIC) were stratified into six structural environments by two fundamental structural factors: level of gender inequality and prevalence of sexual IPV. To examine how transcending community norms shape the odds of reporting sexual IPV across environments, six identical multilevel models were fit including statistical deviation from 13 community norms as key covariates. Positive deviance from community norms is associated with both increased and decreased odds of reporting sexual IPV and the nature of these relationships vary by structural environment. Positive deviance had a greater effect on reporting sexual IPV in highly unequal societies. Positive deviance from fertility preferences and controlling behavior was associated with increased odds of sexual IPV across contexts. The accrual of social capital and differences in female autonomy across environments may be two ways positive deviance alters sexual IPV risk. A better understanding of how the salience of community norms varies by structural environment and how transcending these norms shapes the risk for sexual violence may help highlight pathways for interventions to change restrictive social norms and increase female empowerment without increasing the risk of sexual IPV.

2020 ◽  
pp. injuryprev-2019-043433
Author(s):  
M Claire Greene ◽  
Lori Heise ◽  
Rashelle J Musci ◽  
Andrea L Wirtz ◽  
Renee Johnson ◽  
...  

BackgroundAlcohol use is a consistent correlate of intimate partner violence (IPV) in low-income and middle-income countries (LMICs). However, the magnitude of this association differs across studies, which may be due to contextual and methodological factors. This study aims to estimate and explore sources of heterogeneity in the association between alcohol use and IPV in 28 LMICs (n=109 700 couples).MethodsIn nationally representative surveys, partnered women reported on IPV victimisation and male partner’s alcohol use. We estimated the relationship between alcohol use and IPV using logistic regression and full propensity score matching to account for confounding. Country-specific ORs were combined using a random-effects model. Country-level indicators of health and development were regressed on ORs to examine sources of variability in these estimates.ResultsPartner alcohol use was associated with a 2.55-fold increase in the odds of past-year IPV victimisation (95% CI 2.27 to 2.86) with substantial variability between regions (I2=70.0%). Countries with a low (<50%) prevalence of past-year alcohol use among men displayed larger associations between alcohol use and IPV. Exploratory analyses revealed that colonisation history, religion, female literacy levels and substance use treatment availability may explain some of the remaining heterogeneity observed in the strength of the association between alcohol use and IPV across countries.ConclusionPartner alcohol use is associated with increased odds of IPV victimisation in LMICs, but to varying degrees across countries. Prevalences of male alcohol use and cultural factors were related to heterogeneity in these estimates between countries.


2021 ◽  
pp. 088626052110163
Author(s):  
Samuel Kebede ◽  
Anne-Laura Van Harmelen ◽  
Andres Roman-Urrestarazu

Intimate Partner Violence (IPV) has been linked to poor health. Economic position may be an important risk factor for IPV. We examined the association between economic position and IPV at country and individual levels. We analyzed Demographic and Health Surveys data of 187,716 ever-partnered women between ages 10 and 59 from 20 low- and middle-income countries. We calculated direct age-standardized 12-month prevalence of physical IPV and performed ecological analysis using Gini coefficients and Concentration indexes to assess correlation with 12-month prevalence of physical IPV. We conducted multivariable logistic regression for each country to assess the association between wealth status and physical IPV and a meta-analysis of the regression model to present results across countries. Compared to the Poorest quintile, odds of IPV among wealthier quintiles varied by country. In the Middle quintile, India had significantly reduced IPV (OR 0.75, 95%CI: 0.68-0.83). In the Richer and Richest quintiles, 4 and 6 countries had significant reductions in IPV, respectively. Only Mozambique was found to have significant increased IPV in the wealthiest quintile (OR 2.51, 95%CI: 1.45-4.38). Gini coefficient and physical IPV had a correlation coefficient of 0.502 ( p value 0.033), while Concentration index had –0.276 ( p value .253). Standardized prevalence for physical IPV ranged from 1.58% to 18.91%. Findings suggest that the relationship between wealth and IPV vary considerably in the included low- and middle-income countries, and that risk of IPV may not necessarily be higher among women in lower wealth brackets. Mozambique was the only country with increased odds of IPV among the Richest group as compared to the Poorest group. This study provides evidence IPV may transcend economic boundaries, and that studies looking at the link between inequality and IPV are paramount for designing adequate preventative policies.


Contraception ◽  
2016 ◽  
Vol 94 (4) ◽  
pp. 434
Author(s):  
L Maxwell ◽  
H Brahmbhatt ◽  
K Devries ◽  
A Benedetti ◽  
J Wagman ◽  
...  

2020 ◽  
Vol 4 (2) ◽  
pp. 241-258
Author(s):  
Nicholas Metheny ◽  
Rob Stephenson

Intimate partner violence is a global public health concern that is widely under-reported. Socio-demographic factors of the interviewer may contribute to a reluctance to report violence. The introduction of the fieldworker survey to the 2015 Zimbabwe Demographic and Health Survey provides the first opportunity to test associations between interviewer characteristics and the reporting of intimate partner violence in the largest source of IPV data on intimate partner violence available for low- and middle-income countries. Three separate, multilevel logistic regression models were used to examine associations between the reporting of physical, sexual and emotional intimate partner violence and interviewer characteristics (age, sex and marital status, as well as differences in these indicators between interviewer and respondent), language of the interview and the interviewer’s previous experience conducting the Demographic and Health Survey. Previous experience as a Demographic and Health Survey interviewer was associated with significantly lower odds (OR: 0.67) of reporting physical intimate partner violence. Researchers should consider using the fieldworker data set in future studies to control for potential interviewer error, account for the clustering of data by interviewer and increase the robustness of Demographic and Health Survey analyses. Understanding how interviewers may shape the reporting of intimate partner violence is a step towards accurately measuring its burden in low- and middle-income countries.


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