Social norms and women's risk of intimate partner violence in Nepal

• Type of Material: Article
• Authors: Cari Clark, Emory University; Gemma Ferguson, Equal Access International; Binita Shrestha, Equal Access International; Prabin Nanicha Shrestha, Equal Access International; J. Michael Oakes, University of Minnesota; Jhumka Gupta, George Mason University; Susi McGhee, Emory University; Yuk Fai Cheong, Emory University; Kathryn Yount, Emory University
• Language: English
• Date: 2018-04-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2018 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.socscimed.2018.02.017
• Title of Journal or Parent Work: Social Science and Medicine
• ISSN: 0277-9536
• Volume: 202
• Start Page: 162
• End Page: 169
• Grant/Funding Information: The Change Starts at Home Project was funded by UK aid (P06254) from the UK government, via the What Works to Prevent Violence Against Women and Girls Global Programme (www.whatworks.co.za).
• Keywords: CLUSTER; Domestic violence; Social Sciences; Social norms; GENDER NORMS; Prevention; Intimate partner violence; EDUCATION; Nepal; EXPERIENCE; ATTITUDES; Social Sciences, Biomedical; Biomedical Social Sciences; MULTILEVEL; Science & Technology; Public, Environmental & Occupational Health; KATHMANDU; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Public Health; Sociology, Public and Social Welfare

Abstract

Social norms increasingly are the focus of intimate partner violence (IPV) prevention strategies but are among the least examined contextual factors in quantitative violence research. This study assesses the within-community, between-community, and contextual effect of a new measure of social norms (PVNS: Partner Violence Norms Scale) on women's risk of IPV. Data come from baseline surveys collected from 1435 female, married, reproductive-age participants, residing in 72 wards in three districts (Chitwan, Kapilvastu, Nawalparasi) in Nepal who were enrolled in a cluster randomized trial testing the impact of a social behavioral change communication intervention designed to prevent IPV. Results of unconditional multilevel logistic regression models indicated that there was cluster-level variability in the 12-month prevalence of physical (ICC = 0.07) and sexual (ICC = 0.05) IPV. Mean PVNS scores also varied across wards. When modeled simultaneously, PVNS scores aggregated to the ward-level and at the individual-level were associated with higher odds of physical (ORind = 1.12, CI = 1.04, 1.20; ORward = 1.40, CI = 1.15, 1.72) and sexual (ORind = 1.15, CI = 1.08, 1.24; ORward = 1.47, CI = 1.24, 1.74) IPV. The contextual effect was significant in the physical (0.23, se = 0.11, t = 2.12) and sexual (0.24, se = 0.09, t = 2.64) IPV models, suggesting that the ward-level association was larger than that at the individual-level. Adjustment for covariates slightly attenuated the ward-level association and eliminated the contextual association, suggesting that individual perceptions and the collective community phenomena were equally strong predictors of women's risk of IPV and should be taken into consideration when planning interventions. PVNS is a promising measure of social norms underpinning women's risk of IPV and warrants further psychometric testing.