Abstract: This study was aimed to estimate the prevalence of different kinds of domestic violence against women in an Iranian population and to explore their attitudes. A cross-sectional survey was conducted in Kerman, Iran. Three hundred ninety eight women referring to randomly selected health centers were interviewed in early 2005. The questionnaire explored the women`s views regarding domestic violence and their experiences of domestic violence during the year before interview. Ignoring women`s capabilities by their spouses (36.7%) was the most frequent type of violence. Roughly 27% of them were beaten by their husbands over preceding year. The respondents showed the least agreement with ‘violence toward wife ceases during pregnancy’. Although the findings may not be generalizable to other parts of the country due to cultural diversity, considering the high prevalence of different types of domestic violence it should be regarded as a priority for health service policy.
INTRODUCTION
According to a report issued by the World Health Organization (Heise and Garcia-Moreno, 2002) between 10 and 52% of women from around the world report that they had been physically abused by an intimate partner at some point in their lives and between 10 and 30% of women had experienced sexual violence by an intimate partner.
Domestic violence leads to many physical and psychological injuries to women such as poor health, depression and Post Traumatic Stress Disorder (PTSD) as well as anxiety and suicide (Coker et al., 2000). Indirect psychological effects of violence can give rise to nonspecific physical symptoms such as stomachache, headache and alimentary tract problems (Kernic et al., 2000).
In research about domestic violence the role of culture, as well as cultural and religious beliefs and attitudes of people about violence should be considered (Goel, 2005). Such beliefs may affect responding strategies of legal and social institutions to it (Nayak et al., 2003). Cultural attitudes frequently justify violence against women on such grounds that they have not fulfilled their housekeeping duties, have not been faithful, or that their dress or behavior has elicited violence (Kim and Motsei, 2002). In many instances, such social norms as shame, fear, denial and self-reproach will prevent victims from seeking help. Moreover, the idea that a victim is to blame will strip them of self-esteem in the long run (Koss, 2000).
Due to diversity of attitudes in various cultures, studies on violence against women can reveal new points in every culture. Such studies in Iran have been meager and their precedence compared to western countries (Since, 1970) has been negligible. However, this does not mean that violence is not a problem in our society. In Iran, such studies focused to prevalence of domestic violence (Faramarzi et al., 2005a; Ghazizadeh, 2005) and the cultural views regarding of domestic violence was missed. This study is aimed at estimating the prevalence of different forms of domestic violence in Iranian women population and to explore their attitude toward the issue. It also presents the groups most vulnerable to physical violence.
MATERIALS AND METHODS
This survey was conducted in Kerman the capital city of the largest province of Iran located in Southern Iran in early 2005. In this study, 420 women who referred to 12 randomly selected health centers located in different areas of city aged between 17 to 70 were requested to take part in an interview. Before interviewing the respondents were insured of the confidentiality of their answers and views and after obtaining their consent they were interviewed in a private area. The questionnaire consisted of three parts, background questions, questions regarding domestic violence experiences and questions requesting the attitude toward domestic violence. Using likert scale ranging from high disagreement (score 1) to high agreement (score 5) and items considering experiences of abuse during the year before interview. Content validity of the questionnaire was established by an extensive literature review and an expert panel. The overall attitude scale stood on acceptable internal consistency (α = 0. 81).
A Principal Component Analysis (PCA) with Varimax rotation on the 16 attitude items did not yield coherent factors. So we examined separately the 16 items scores. In order to determine which questions generated positive or negative attitude at a greater than chance level, the mean Likert scores on each item was calculated and compared to a hypothesized mean of 3 (representing a natural score) using t-test, in this regard the significance level was set at alpha <0.003 for the comparisons regarding Bonfronni adjustment. Differences between the percent of women reporting violence by each subgroup were evaluated using chi square test. Statistical analyses were performed using SPSS software (version 15).
RESULTS AND DISCUSSION
Of 420 women invited for interview, 398 individuals (94.7%) participated in this study. The mean ( ± SD) age of the participating women was 34.4 ( ± 10.3). The mean numbers of children ever born was 3.0 ( ± 2.2). More than 8% of them were illiterate (Table 1). Fifty one percent of women and 95% of their husbands were employed (Table 1). Nearly 27% of women were beaten by their husband over preceding year. Threatening to divorce was the most common type of threatening violence (i.e., more than 13%) and ignoring women’s capabilities by their spouses (36. 7%) was more frequent than other forms of emotional violence (Table 2). About 25% of women reported any type of sexual violence during preceding year (Table 2).
Physical violence was reported by women who had a higher education, employed and lived with a mentally-ill husband (Table 3).
In Table 4, the mean scores are included for each attitude statement as well as the P value, which tests whether the average score is different from the neutral score of 3.0. There was no significant difference comparing to the neutral value of 3.0 regarding questions 3, 7, 8, 9, 11, 14 and 16.
Respondents most frequently agreed with the statement violence and wife abuse by husband is a normal part of marital life and showed the least agreement with the statement violence toward wife ceases during pregnancy (Table 4).
| Table 1: | Selected characteristics of women studied about domestic violence (n = 398) |
The study found alarming rate of different types of violence against women by their husbands (Table 2). Relevant studies conducted in the country showed that the prevalence of physical, emotional and sexual violence among North Iranian women were 81. 5, 42. 4 and 15%, respectively (Faramarzi et al., 2005b). The prevalence rates differ widely from country to country. In Japan 50% of women reported experiencing at least one type of emotional violence and 20% experienced sexual violence and the prevalence of physically abused women was more than 30% (Weingourt et al., 2001). A study in Turkey showed even higher rates of domestic violence; the prevalence of physical, sexual and emotional domestic violence was, respectively 57, 65 and 30.7% (Kocacik and Dogan, 2006).
The difference in figures may be to some extent due methodological differences in cohort recruitment (those who refer to police stations, coroner or emergency ward of hospitals) (Faramarzi et al., 2005b; Ghazizadeh, 2005) but may also be due to cultural and social differences (Heise, 1998).
The study demonstrated that some acts, such as beating and shoving were more prevalent than threatening to kill with a gun or knife (Table 2) which may be related to impulsiveness in families or due to different cultural attitudes toward killing (Heise, 1998; Jewkes et al., 2002; Haj Yahia, 2003). Meanwhile the prevalence of physical violence was higher in more educated and employed women (Table 3). Whilst some studies conducted in Iran, as well as other countries demonstrated a reverse relationship between violence and education and occupational status of women (Jewkes et al., 2002; Faramarzi et al., 2005a; Ghazizadeh, 2005; Romito et al., 2005), others report that working women are exposed to more violence (Ezazy, 2003). Researchers in the first group argue that less economic dependence on husband reduces violence (Schuler et al., 1996). However, it seems that inhibitory role of working is not limited to economic aspects, but working women gain more social status and opportunities including taking part in social networks, which gives them more self-esteem and they would have more access to information or other social resources (Jewkes et al., 2002). On the contrary, some researches believe that economic independence of women is a source of tension in the family which may lead to an increase in the probability of domestic violence (International Center for Research on Women, 2000). Since in the Iranian traditional culture man is the breadwinner of family, women’s occupation and earning will face men with a kind of masculine identity crisis, which will undermine traditional image of an ideal man and so he tries to improve that image through violence (Nayak et al., 2003). The finding that the man’s education and occupation had no significant role in the prevalence of violence shows that cultural factors are much more effective than demographic ones (Kim and Motsei, 2002; Faramarzi et al., 2005a).
| Table 2: | Frequency of violence over preceding year among studied women in 2005 (n = 398) |
| Table 3: | Frequency distribution of physical violence according to selected characteristics |
| Values are given as n (%) of respondents | |
Psychological disorders in men have been accompanied by increased prevalence of domestic violence and this has been noted in many studies (Nestor, 2002). Impulsiveness as well as borderline and antisocial personality types has been mentioned to increase spouse abuse (Edwards et al., 2003).
Another form of violence against women is threat to divorce or taking children from mothers. In Iran, threatening to divorce is an act of violence against women because it means losing financial support, social respect as well as children.
| Table 4: | Mean scores of the responses to the attitude statements and results of comparing with neutral score (N = 398) |
| †: Higher scores reflect more agreement. *: Significant difference comparing neutral value of 3.0 on the Likert scale | |
Slightly more than 19% of studied women complained about having sex without their consent and 5% reported inattention of their husband to their sexual needs. According to the World Health Organization multi-country study the prevalence of sexual violence ranged from 6 to 49% (Garcia-Moreno et al., 2006). These observed differences in the rate of sexual violence may be due to differences in how it was defined and also cross-cultural differences (Garcia-Moreno et al., 2006).
It should be noteworthy that some forms of violence could be overshadowed by other forms. For example, psychological consequences of beating or verbal abuse can be easily overshadowed by physical injury. Therefore, the magnitude of nonphysical violence may be higher than what our study revealed.
The attitude which sees violence to be a private affair between man and woman was identified in the study (Table 4), which is a precipitating factor that has always worked to intensify violence (Hou et al., 2004). One of the most important notions in this regard, is much emphasis laid on privacy of home. Privacy of home environment makes family members to have difficulty for giving voice to their problems. In addition to home privacy, traditional cultural notions including contempt from other people, fears of being labeled with inappropriate conduct or fears about more violence from spouse are among important factors preventing women from seeking help (Shoham, 2005; Haj Yahia, 2003; Griffith et al., 2006).
The mean attitude scores showed that overall, the studied women disagreed with the woman’s full obedience to her husband (Table 4). Absolute obedience to husband is an attitude contrary to the belief of most women who have recognized their rights and give voice to their own ideas. Agreement to complete obedience toward husband varied from 40 to 53% in different nations (Amoakohene, 2004).
A large percentage of women (43%) believed that women themselves are the most important catalysts for domestic violence. This is rooted in traditional beliefs that women’s behavior provokes men to assault (Amoakohene, 2004).
The studied women believed that if a woman leaves her home as a sign of protest after violence from man, this would curtail further violence from her spouse (Table 4). Among major reasons for leaving home in protest, researchers have mentioned hope in improving husband’s behavior, fears about increased violence and even death at the hands of husband, lack of family, financial and social support as well as children as a factor of threat against women (Hindin, 2003). It needs to further studies to elucidate the effect of leaving home on the rate of violence especially in non-Western countries.
More than half of the studied women believed that violence abated during pregnancy. This denotes the cultural notion that a child works to cement marital relationship and make man behave more sensibly. However, some studies have even reported escalation of violence during pregnancy (McFarlane et al., 1996).
Tolerating violence by women for the sake of children or for the fear of losing financial support indicates implicit submission to violence or, at least, lack of disagreement to it (Amoakohene, 2004). Such ideas that violence will abate as a result of submission, the right of man to prevent his wife from working and prescribing violence when a husband doubts faithfulness of his wife indicate accepted cultural norms about women’s rights that determine a woman’s behavior (Haj Yahia, 2002). Such an acceptance of domestic violence by women will lead to escalation of violence in society and family.
In conclusion, although the finding may not be generalized to other parts of the country owing to cultural diversity, considering the high prevalence of different types of domestic violence it should be regarded as a priority for health policy makers.