Intimate partner violence in Nepal: Latent patterns and association with depressive symptoms

• Type of Material: Article
• Authors: Cari Clark, Emory University; Yuk Cheong, Emory University; Jhumka Gupta, George Mason University; Gemma Ferguson, Equal Access International; Binita Shrestha, Equal Access International; Prabin Nanicha Shrestha, Equal Access International; Kathryn Yount, Emory University
• Language: English
• Date: 2019-12-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2019 The Authors
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ssmph.2019.100481
• Title of Journal or Parent Work: SSM - Population Health
• Volume: 9
• Start Page: 100481
• End Page: 100481
• Grant/Funding Information: The funds were managed by the South African Medical Research Council.; This manuscript has been funded by a grant (#P06254) from UK aid from the UK government, via the What Works to Prevent Violence Against Women and Girls? Global Programme (www.whatworks.co.za).
• Keywords: Domestic violence; Latent class analysis; Nepal; IPV; Intimate partner violence
• Research Categories: Health Sciences, Public Health

Abstract

Existing data suggest that there are distinct patterns (or classes) of intimate partner violence (IPV) experience that depart from dichotomous categorizations used to monitor progress toward Sustainable Development Goal 5.2. Less is known about the patterning of IPV in non-Western settings. This study estimates distinct classes of IPV experience in Nepal and examines potential community-level variability in these classes and in the association between IPV class and depressive symptoms. This study used data collected in 2016 from a random sample of Nepalese married women of reproductive age (N = 1440) living in 72 communities in three districts (Nawalparasi, Chitwan, and Kapilvastu). We used fixed effects and random effects latent class models of 2 through 6 classes. We fit a negative binomial regression model adjusted for relevant confounders to examine the relationship of the latent IPV classes with depressive symptoms. A four-class model was the best fitting. It included a “low exposure” class (77.36% of the sample) characterized by a low probability of experiencing any form of IPV, a “sexual violence” class (9.03% of the sample) characterized by a high probability of experiencing a form of sexual violence, a “moderate violence” class (6.60% of the sample) characterized by modest probabilities of experiencing less severe emotional and physical IPV, and a “systematic violence” class (7.01% of the sample) characterized by a high probability of being exposed to all forms of IPV. Adding random effects did not improve model fit, suggesting no community-level variations in classes. Relative to membership in the low exposure class, membership in all other classes was associated with a higher count of depressive symptoms. Those in the systematic class had a mean weighted symptom count 2.29 times that of the low exposure group. Classes of IPV exposure must be identified to ensure that surveillance and programming are attuned to women's experiences of violence.