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Epidemiology International

Volume 3, Issue 2 - 2018, Pg. No. 17-23


Peer Reviewed & Open Access Journal

Research Article

Prevalence and Determinants of Domestic


Violence among Attendees of an Antenatal
Clinic in a Tertiary Care Teaching
Hospital in Delhi, India
Suneela Garg1, MM Singh2, Archana Ramalingam3, Indu Bala4, Charu Kohli5,
Deeksha Khurana6, Komal Kumari7
1
Director-Professor and Head, 2Director Professor, 3Senior Resident, 4Research Officer, 6Program Officer, SH2030, 7Research
Assistant, Department of Community Medicine, Maulana Azad Medical College, New Delhi.
5
Assistant Professor, Department of Community Medicine, North DMC Medical College &
Hindu Rao Hospital, New Delhi.
DOI: https://doi.org/10.24321/2455.7048.201809

Abstract
Apparently healthy pregnant women with a gestational age of < 20 weeks were interviewed about
sociodemographic details, marital history, antenatal history and presence of domestic violence. Of the
428 pregnant women, 31.3% suffered from domestic violence. Emotional and verbal abuse (58.2%) was
the most common form. Women with younger age at marriage and with assisted conception were at a
higher risk for suffering from domestic violence. Pregnant wives of men with a lower level of education,
unemployment or employment as unskilled labourers and addiction to alcohol and tobacco were at higher
risk for domestic violence.

Keywords: Violence, Determinants, Delhi

Introduction or well-being, whether mental or physical, of the aggrieved


person or tends to do so and includes causing physical
Violence against women is considered as a Human Rights abuse, sexual abuse, verbal and emotional abuse and
violation and is increasingly being recognised as an important economic abuse; or b) harasses, harms, injures or endangers
issue worldwide. The United Nations defines violence the aggrieved person with a view to coerce her or any other
against women as “any act of gender-based violence that person related to her to meet any unlawful demand for any
results in, or is likely to result in, physical, sexual or mental dowry or other property or valuable security; or c) has the
harm or suffering to women, including threats of such effect of threatening the aggrieved person or any person
acts, coercion or arbitrary deprivation of liberty, whether related to her to any conduct mentioned in clause (a) or
occurring in public or private life.”1 The Protection of clause (b); or d) otherwise injures or causes harm, whether
Women from Domestic Violence Act 2005, defines domestic physical or mental, to the aggrieved person.”2 The World
violence as “any act, omission or commission or conduct of Health Organisation in collaboration with London School
the respondent shall constitute domestic violence in case it: of Hygiene and Tropical Medicine reported that nearly
a) harms or injures or endangers the health, safety, life, limb 35% of women have experienced some form of intimate

Corresponding Author: Dr. Suneela Garg, Department of Community Medicine, Maulana Azad Medical College, New Delhi.
E-mail Id: gargsuneela@gmail.com
Orcid Id: https://orcid.org/0000-0002-2196-1607
How to cite this article: Garg S, Singh MM, Ramalingam A et al. Prevalence and Determinants of Domestic Violence among
Attendees of an Antenatal Clinic in a Tertiary Care Teaching Hospital in Delhi, India. Epidem Int 2018; 3(2): 17-23.

Copyright (c) 2018 Epidemiology International (ISSN: 2455-7048)


Garg S et al.
Epidem. Int. 2018; 3(2) 18

partner violence.3 In addition to being a Human Rights issue, sex, type of family, number of people in the house, total
domestic violence also has a lot of health consequences. monthly family income, religion, educational level of each
This may range from depression, post-traumatic stress participant and their husbands was used for data collection.
disorder, sleep difficulties, eating disorders, emotional Personal habits of women and her partner such as tobacco
distress, and suicide attempts. During pregnancy domestic use, consumption of alcohol, substance abuse, history of
violence results in miscarriage, stillbirth, preterm delivery reproductive tract infections (RTIs), history of any criminal
and low birth weight.3 Few studies have been done in act and assessment of various aspects of domestic violence
India to estimate the burden of domestic violence among was done. The study was approved by the Institutional
pregnant women and the factors associated with domestic Ethics Committee. Informed consent was obtained from the
violence.4,5 With this background, a study was done among study participants. Confidentiality of the data was ensured.
the attendees of an antenatal clinic in Delhi to find out the Those who were found to suffer from domestic violence
prevalence and determinants of domestic violence. were referred for counselling services and were provided
with details of help line numbers. The data was analysed
Materials and methods using SPSSS version 17. The continuous variables were
reported as mean, and standard deviation and categorical
This was a cross sectional study conducted in Antenatal variables were reported as percentages. Chi-square test
clinic of a tertiary care hospital located in Central Delhi. The and student’s t-test were used to test the associations
antenatal Out Patient Department (OPD) in the hospital between various factors and domestic violence. A p value
takes place six days a week (Monday to Saturday). The of <0.05 will be considered as significant.
average antenatal load in a routine OPD was approximately
50 new pregnant women (registering for the first time) Results
with an average of 10 women with gestation period up
to 20 weeks. All pregnant women residing in Delhi during Demographic details
past one year who have gestation period up to 20 weeks
and attending ANC clinic of hospital who were apparently The mean age of the study participants was found to be
healthy women based on self-report and those who gave 24.6±3.8, and the mean age at marriage was 20.6±2.8.
consent were included in the study. Females with mental Almost all the antenatal women were married (99.8%) and
handicap, incapacitating physical health problems (acute, more than two third were living in joint families (67.3%).
chronic, communicable and non-communicable diseases More than half of the women were Muslims (55.8%), and
including HIV/AIDS, cancer, diabetes, heart problems) nearly seventy percent were belonging to the General
were excluded. A pre-tested questionnaire compromising caste (69.4%). Most of them were unemployed (96%) and
of socio-demographic and obstetric details like age of were living in Delhi for more than five years (80.6%). Nearly
subject, age of marriage, duration of marriage, the age thirty percent (28.5%) were educated up to the level of
gap of couple, occupation, gravidity, parity, planned or high school, and another 15% were illiterate. Nearly half
unplanned pregnancy, number of living children and their of the population belonged to either Upper Class (15.4%)
or Upper Middle Class (30.4%) (Table 1).

ISSN: 2455-7048
DOI: https://doi.org/10.24321/2455.7048.201809
Garg S et al.
19 Epidem. Int. 2018; 3(2)

Table 1.Demographic details of the study subjects


Characteristics Number of study subjects (%)
Family Type
Joint 288 (67.3)
Nuclear 140 (32.7)
Marital Status
Married 427 (99.8)
Divorced 1 (0.2)
Education Status
Illiterate 64 (15)
Below Primary 13 (3)
Primary 82 (19.2)
High School 122 (28.5)
Senior Secondary 82 (19.2)
Graduate and above 65 (15.2)
Occupation
Unemployed/Housewife 411 (96)
Unskilled worker 4 (0.9)
Semi-skilled worker 6 (1.4)
Skilled worker 2 (0.5)
Semi-Professional 1 (0.2)
Professional 4 (0.9)
Socio-economic status (Modified BG Prasad)
Upper Class 66 (15.4)
Upper Middle Class 130 (30.4)
Middle Class 100 (23.4)
Lower Middle Class 46 (10.7)
Lower Class 4 (0.9)
Don’t Know the Per capita income 82 (19.2)
Religion
Hindu 188 (43.9)
Muslim 239 (55.8)
Sikh 1 (0.2)
Caste
Scheduled Caste 53 (12.4)
Scheduled Tribe 4 (0.9)
Other Backward Class 74 (17.3)
General 297 (69.4)
Duration of stay
>=1 years to <3 years 55 (12.9)
>=3 years to 5 years 28 (6.5)
>=5 years 345 (80.6)

ISSN: 2455-7048
DOI: https://doi.org/10.24321/2455.7048.201809
Garg S et al.
Epidem. Int. 2018; 3(2) 20

Characteristics of the Husbands of the study Parity


population
0 205 (47.9)
The mean age of the husbands was found to be 28.2±4.8. 1 158 (36.9)
Only less than two percent of the husbands of the study 2 53 (12.4)
subjects were unemployed (1.2%), and nearly thirty percent
were employed as semi-skilled workers (29.4%). One-third >2 12 (2.8)
of the husbands had a history of abusing either alcohol or Live Birth
tobacco or both (Table 2). 0 212 (49.5)
Table 2.Characteristics of the Husbands of the study 1 169 (39.5)
population
2 45 (10.5)
Education Status Number (%) 3 2 (0.4)
Illiterate 57 (13.3) Abortions
Below Primary 7 (1.6) 0 283 (66.1)
Primary 88 (20.6) 1 109 (25.5)
High School 123(28.7) 2 27 (6.3)
Senior Secondary 84 (19.6) >2 9 (2.1)
Graduate and above 69 (16.1) Planned pregnancy
Occupation Yes 303 (70.8)
Unemployed 7 (1.6) No 125 (29.2)
Unskilled worker 95 (22.2) Discharge per vaginum
Semi-skilled worker 126 (29.4) Yes 179 (41.8)
Skilled worker 84 (19.6) No 249 (58.2)
Semi-Professional 67 (15.7) Bleeding per vaginum
Professional 24 (5.6) Yes 19 (4.4)
History of Tobacco/ Alcohol Use No 409 (95.6)
Yes 142 (33.2) History of drug intake
No 286 (66.8) Yes 30 (7)
History of Extramarital Affairs No 398 (93)
Yes 5 (1.2) History of fever with rashes
No 423 (98.8) Yes 89 (20.8)
No 339 (79.2)
Clinical Details of the study subjects
History of radiation exposure
Nearly one out of every four study participants had, at least, Yes 6 (1.4)
one abortion (25.5%) in the past, and one-third was of a No 426 (98.6)
gravida order of more than 2 (33.6%). Nearly forty percent
History of pedal oedema
had one live birth in the past, and another ten percent had
two live births. More than two third (70.2%) of the study Yes 11 (2.6)
participants reported that the present pregnancy was a No 417 (97.4)
planned one. Nearly forty percent (41.8%) had reported
of having a history of abnormal vaginal discharge (Table 3). Prevalence of Domestic Violence Among the attendees
Table 3.Clinical details of the study participants of an Antenatal Clinic and Typology of Violence

Clinical details Number (%) Nearly one-third of the study subjects (n=134,31.3%) had
suffered from some form of Domestic Violence. The most
Gravida
common type of violence was emotional (58.2%) followed
<=2 284 (66.4) by economical (40.3%). The other types of violence were
>2 144 (33.6) physical (31.3%) and sexual (21.4%) (Table 4).

ISSN: 2455-7048
DOI: https://doi.org/10.24321/2455.7048.201809
Garg S et al.
21 Epidem. Int. 2018; 3(2)

tribes suffered from domestic violence whereas only 23%


Table 4.Typology of Domestic Violence among the study
of Other Backward Classes and 31.1% of general caste
population (N=134)
suffered from domestic violence (p-value: 0.046). Half of
Typology of domestic Number of subjects the women whose husbands had studied below primary
violence (%) level of education suffered from domestic violence whereas
Physical 42 (31.3) it was lower among those whose husbands had a better
education status (p-value: 0.00013). 43.6% of women whose
Economic 54 (40.3)
husbands were unemployed or were unskilled labourers
Emotional 78 (58.2) suffered from domestic violence whereas it was much lower
Sexual 38 (28.4) in the other groups (p-value: 0.0028) 38.7% of women
whose husbands were either abusing alcohol or tobacco
Associated Factors for Domestic Violence suffered from domestic violence whereas only 27.6% of
the others suffered from domestic violence (p-value: 0.020)
The mean age at marriage of women who suffered from 43.5% of those women who had an assisted conception
domestic violence (20.1±3.1) was lesser than those who suffered from domestic violence whereas only 29.2% of
did not suffer (20.8 ±2.7) from domestic violence (p-value: women who had spontaneous conception suffered from
0.014). Nearly half (46.3%) of the Scheduled caste and domestic violence (p-value : 0.025) (Table 5).
Table 5.Associated Factors for Domestic Violence among the study population
Characteristics Antenatal women who Antenatal Women who did Chi p-value
suffered from Domestic not suffer from domestic Square
Violence N (%) violence N (%)
Family Type
Joint 93 (32.3) 195 (67.7) 0.396 0.529
Nuclear 41 (29.3) 99 (70.7)
Education Status
Illiterate 22 (34.4) 42 (65.6)
Below Primary 4 (30.8) 9 (69.2)
8.785 0.118
Primary 22 (26.8) 60 (73.2)
High School 49 (40.2) 73 (59.8)
Senior Secondary 23 (28) 59 (72)
Graduate and above 14 (21.5) 51 (78.5)
Occupation
Unemployed/Housewife 127 (30.9) 284 (69.1)
Unskilled worker 2 (50) 2 (50)
2.124 0.832
Semi-skilled worker 2 (33.3) 4 (66.7)
Skilled worker 1 (50) 1 (50)
Semi-Professional 0 1 (100)
Professional 2 (50) 2 (50)
Religion
Hindu 66 (35.1) 122 (64.9)
Muslim 67 (28) 172 (72) 4.647 0.098
Sikh 1 (100) 0
Caste
SC 25 (46.3) 29 (53.7)
ST 0 4 (100) 9.861 0.020
OBC 17 (23) 57 (77)
General 92 (31.1) 204 (68.9)

ISSN: 2455-7048
DOI: https://doi.org/10.24321/2455.7048.201809
Garg S et al.
Epidem. Int. 2018; 3(2) 22

Duration of stay
>=1 years to <3 years 17 (30.9) 38 (69.1)
>=3 years to 5 years 8 (28.6) 20 (71.4) 0.115 0.944
>=5 years 109 (31.6) 236 (68.4)
Education Status of Husband
Illiterate 28 (48.3) 30 (51.7)
Below Primary 4 (66.7) 2 (33.3)
20.219 0.003
Primary 16 (18.2) 72 (81.8)
High School 38 (31.9) 81 (68.1)
Senior Secondary 26 (31.1) 58 (69)
Graduate and above 20 (29) 49 (71)
Occupation status of husband
Unemployed 3 (37.5) 5 (62.5)
Unskilled worker 42 (44.2) 53 (55.8)
Semi-skilled worker 38 (30.4) 87 (69.6)
12.369 0.054
Skilled worker 25 (29.8) 59 (70.2)
Clerical/Shop worker 16 (23.9) 51 (76.1)
Semi-Professional 4 (16.7) 20 (83.3)
Professional 6 (24) 19 (76)
History of Tobacco/ Alcohol Uses
by the Husband
Yes (n=142) 55 (38.7) 87 (61.3) 5.446 0.020
No (n=286) 79 (27.6) 207 (72.4)
History of Spontaneous
Conception
Yes (n=316) 92 (29.1) 224 (70.9) 3.878 0.04
No (n=46) 20 (43.5) 26 (56.5)

Discussion mental abuse. It was found that women whose husbands


had a lower education status, a partner who abuses alcohol
A total of 428 individuals were interviewed at the antenatal and tobacco, low socioeconomic status and illiteracy were
OPD, and it was found that nearly 31.3% was found to found to be risk factors for domestic violence. These findings
have some form of Domestic Violence. Among those who are similar to that of the present study.5
experienced domestic violence it was found that Emotional
and verbal abuse (58.2%) was the most common form. In a study done in Nigeria nearly, 7.4% of the total 392
Women with younger age at marriage and with assisted respondents were found to suffer from domestic violence.
conception were at a higher risk for suffering from domestic More than half of them were found to suffer from physical
violence. Pregnant wives of men with a lower level of violence (58.6%). Pregnant women’s education status and
education, unemployment or employment as unskilled occupation status were the major predictors of domestic
labourers and addiction to alcohol and tobacco were at violence.7 The lower prevalence of domestic violence in
higher risk for domestic violence. this study may be due to differences in socio-demographic
factors in the two regions.
In a review done by pregnant women in developing
countries, it was found that nearly 4% to 29% of the women In a study done among 1379 Brazilian pregnant women,
were found to suffer from domestic violence. The major it was found that nearly 19% suffered from psychological
risk factors were women belonging to a low-income group, violence and another 6.5% from physical and sexual
low education in both partners, and unplanned pregnancy.6 violence. Some of the risk factors identified for violence
was a low level of education of the interviewee, experience
In a study done in Delhi, it was found that nearly 26% of of physical violence in childhood, use of drugs by partner
the women suffered from physical violence and 29% from

ISSN: 2455-7048
DOI: https://doi.org/10.24321/2455.7048.201809
Garg S et al.
23 Epidem. Int. 2018; 3(2)

and consumption of alcohol by a partner.8 In our study also, tectionofWomenfromDomesticViolenceAct2005.pdf.


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Conflict of Interest: None et al. Magnitude of Domestic Violence and Associated
Factors among Pregnant Women in Hulet Ejju Enessie
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ISSN: 2455-7048
DOI: https://doi.org/10.24321/2455.7048.201809

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