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Domestic Violence against Women Domestic Violence against Women attending Primary Health Care Units attending Primary Health Care Units
in Cairo: A cross sectional studyin Cairo: A cross sectional study
Dr. Khaled Mahmoud Abd ElazizDr. Khaled Mahmoud Abd Elaziz Assistant Professor of public health and Assistant Professor of public health and
preventive medicine preventive medicine Faculty of Medicine- Ain ShamsFaculty of Medicine- Ain Shams
UniversityUniversity
Domestic Violence against Women Domestic Violence against Women attending Primary Health Care Units attending Primary Health Care Units
in Cairo: A cross sectional studyin Cairo: A cross sectional study
Amany M Sayed,Amany M Sayed, Khaled M Abd Elaziz, Khaled M Abd Elaziz, Hasnaa A Abou Seif, Hasnaa A Abou Seif,
Iman M BakrIman M Bakr
The United Nations defines violence The United Nations defines violence against women as "any act of against women as "any act of gender-based violence that results gender-based violence that results in, or is likely to result in, physical, in, or is likely to result in, physical, sexual or mental harm or suffering sexual or mental harm or suffering to women, including threats of such to women, including threats of such acts, coercion or arbitrary acts, coercion or arbitrary deprivation of liberty, whether deprivation of liberty, whether occurring in public or in private life."occurring in public or in private life."
Domestic violence against women has Domestic violence against women has been acknowledged worldwide as a been acknowledged worldwide as a violation of basic human rights. It is violation of basic human rights. It is violence that takes place at home or violence that takes place at home or within the family. within the family.
Recent global prevalence figures Recent global prevalence figures indicate that 35% of women worldwide indicate that 35% of women worldwide have experienced either intimate have experienced either intimate partner violence or non-partner sexual partner violence or non-partner sexual violence in their lifetime. violence in their lifetime.
On average, 30% of women who have been in a On average, 30% of women who have been in a relationship report that they have experienced relationship report that they have experienced some form of physical or sexual violence by their some form of physical or sexual violence by their partner. Globally, as many as 38% of murders of partner. Globally, as many as 38% of murders of women are committed by an intimate partnerwomen are committed by an intimate partner
In Egypt the results of 2005 EDHS indicated that In Egypt the results of 2005 EDHS indicated that more than (28%) of females are exposed to more than (28%) of females are exposed to physical violence, About (32%) of women who physical violence, About (32%) of women who reported ever being beaten and have had at least reported ever being beaten and have had at least one birth or are currently pregnant have been one birth or are currently pregnant have been beaten during pregnancy. Beating by an intimate beaten during pregnancy. Beating by an intimate partner remains highly prevalent in Egypt, despite partner remains highly prevalent in Egypt, despite increasing levels of education in the population increasing levels of education in the population and initiatives to reduce wife beating and initiatives to reduce wife beating
Violence against women and the threat of Violence against women and the threat of violence are main barriers of women's violence are main barriers of women's empowerment and equal participation in empowerment and equal participation in society. society.
However, they often go unnoticed and However, they often go unnoticed and undocumented and therefore unresolved. undocumented and therefore unresolved. When stress and violence increase in the When stress and violence increase in the society in general, women's safety at home, society in general, women's safety at home, workplace and community are often workplace and community are often seriously affected seriously affected
Aim of the study:Aim of the study:
To measure prevalence of domestic To measure prevalence of domestic violence among a sample of violence among a sample of women attending PHC units in women attending PHC units in Cairo and to determine associated Cairo and to determine associated risk factors.risk factors.
Subjects and MethodsSubjects and Methods
A A cross section study cross section study started in January 2012 started in January 2012 till end of April 2012 included a convenient till end of April 2012 included a convenient sample of married women attending sample of married women attending different clinics (vaccination, pediatrics, different clinics (vaccination, pediatrics, dentistry, family planning, antenatal care, dentistry, family planning, antenatal care, internal medicine) in two primary health care internal medicine) in two primary health care units in Cairo “Rod El-Farag and El-Darrasa units in Cairo “Rod El-Farag and El-Darrasa The exclusion criteria included women who The exclusion criteria included women who were never married, refused to participate, were never married, refused to participate, and subjects suffering of acute medical and subjects suffering of acute medical condition.condition.
Tools of the study:Tools of the study: An interview questionnaire according to Bardley et An interview questionnaire according to Bardley et
al., 2002 that included questions on different al., 2002 that included questions on different aspects of domestic violence was modified and aspects of domestic violence was modified and used after being tested through a pilot study.(5)used after being tested through a pilot study.(5)
If an adult female patient was eligible to If an adult female patient was eligible to participate, the interviewer explained the purpose participate, the interviewer explained the purpose of the study, reassured the patient that all of the study, reassured the patient that all responses would be kept anonymous to insure responses would be kept anonymous to insure privacy and confidentiality, and then asked for privacy and confidentiality, and then asked for participation. Participants were interviewed after participation. Participants were interviewed after taking their consent while waiting for their taking their consent while waiting for their physicians or after finishing their visit. physicians or after finishing their visit.
The questionnaire was interview questionnaire, it The questionnaire was interview questionnaire, it took about 20 minutes to be answered and it took about 20 minutes to be answered and it included:included:
1-Sociodemographic characteristics: age, marital 1-Sociodemographic characteristics: age, marital status, number of children, educational level of status, number of children, educational level of women and their husbands, occupation of women women and their husbands, occupation of women and their husbands. Also smoking habits and drug and their husbands. Also smoking habits and drug addiction or alcohol use were inquired about.addiction or alcohol use were inquired about.
2-Types of violence to which women is exposed to 2-Types of violence to which women is exposed to (from her husband) during her whole marital life.(from her husband) during her whole marital life.
3-Causes of violence3-Causes of violence 4-Outcome of violence and health complaints of the 4-Outcome of violence and health complaints of the
women women
Controlling violence (Intimate partner Controlling violence (Intimate partner control behavior) control behavior) (9 questions): It included: (9 questions): It included:
husband using Shouting for compliance, husband using Shouting for compliance, Shattering her ambitions and hopes, Shattering her ambitions and hopes,
Embarrassing her in front of others, using Embarrassing her in front of others, using financial abuse, preventing her from money financial abuse, preventing her from money
allowances, taking decisions on his own, allowances, taking decisions on his own, restricting her from contacting her family restricting her from contacting her family
and friends, Spying on her , and locking her and friends, Spying on her , and locking her in the house.in the house.
Threatening violence: Threatening violence: (7 questions): it (7 questions): it included husband using threats for obedience, included husband using threats for obedience,
threat her in front of her children, threat to threat her in front of her children, threat to divorce her, threat to take her children away, divorce her, threat to take her children away, threat by using finger, threat by using sharp threat by using finger, threat by using sharp
objects or weapon and threat to kill her.objects or weapon and threat to kill her. Physical violence:Physical violence: (5 questions): it included (5 questions): it included
husband throwing objects on her, punched or husband throwing objects on her, punched or had a strong grip on her, beat her, beat her had a strong grip on her, beat her, beat her
children and forced her to do sex.children and forced her to do sex.
ResultsResults
Fig. ( ) Distribution of Marital statusFig. ( ) Distribution of Marital status
Married93%
Widow4%
Divorced3%
Mean age of subjects 33.1 10.3 years
Mean age of husbands 39.0 10.0 years
Fig. ( ) Educational status of females in the study and Fig. ( ) Educational status of females in the study and their husbandstheir husbands
13.9
11.2
14.4
40.1
20.3
12.8
8
31.6
15.5
32
0 20 40 60
illiterate
read write
primary
secondary
high
husband
wife
Fig. ( ) Special habits of subjects and their partnersFig. ( ) Special habits of subjects and their partners
3.2
67.4
11.8
7
3.2
0 20 40 60 80
smoking
husband smoking
husband hash
drug addiction
alcohol addiction
Fig. ( ) Distribution of Marital statusFig. ( ) Distribution of Marital status
Married93%
Widow4%
Divorced3%
Mean age of subjects 33.1 10.3 years
Mean age of husbands 39.0 10.0 years
Fig. ( ) Exposure to Domestic violenceFig. ( ) Exposure to Domestic violence
%
Not exposed 24.1
Exposed to one form of violence 20.8
Exposed to two forms 23.5
Exposed to three forms 31.6
Fig. ( ) comparison between age groups and exposure to Fig. ( ) comparison between age groups and exposure to domestic violencedomestic violence
52.1
59.3
50 50.344.8
69.2
0
10
20
30
40
50
60
70
80
90
IP controlviolence
threatviolence
physicalviolence
Young age
old age
*P<0.01 highly significant
*
Fig. ( ) comparison between age of Fig. ( ) comparison between age of intimate partnerintimate partner and and exposure to domestic violenceexposure to domestic violence
49.3
60.2
37.3
59.3
41.3
67.6
0
10
20
30
40
50
60
70
80
90
IP controlviolence
threatviolence
physicalviolence
<=35 years
> 35 years
*P<0.01 highly significant
**
Fig. ( ) comparison between Fig. ( ) comparison between AddictionAddiction of of intimate intimate partnerpartner and exposure to domestic violence and exposure to domestic violence
54.9
60.9
46.3
78.3
53
82.9
0
10
20
30
40
50
60
70
80
90
IP controlviolence
threatviolence
physicalviolence
Non addict
addict
*P<0.01 highly significant
**
Fig. ( ) comparison between Fig. ( ) comparison between Presence of childrenPresence of children and and exposure to domestic violenceexposure to domestic violence
33.3
58.9
25
54
25
61.3
0
10
20
30
40
50
60
70
80
90
IP controlviolence
threatviolence
physicalviolence
no children
with children
*P<0.01 highly significant
***
Fig. ( ) Reasons of domestic violence form women point Fig. ( ) Reasons of domestic violence form women point of viewof view
*out of those exposed to violence any form
N=142* n %
Financial constraints 46 32.4
Children as a cause 38 26.8
Smoking of husband 38 26.8
Husband work 27 19.0
Exposure of husband to violence in his family 27 19.0
Wife herself 24 16.9
Unemployment 15 10.6
Husband addiction 8 5.6
Fig. ( ) Distribution of outcome of physical violence Fig. ( ) Distribution of outcome of physical violence against femalesagainst females
Among all womenN= 187
Women exposed to physical violence
N= 84
No % No %
Cut wounds 22 11.7 22 26.1
Contusions 15 8.0 15 17.8
fracture 5 2.6 5 5.9
Abortion 5 2.6 5 5.9
Death of neonate 4 2.1 4 4.7
Hospital admission 1 0.5 1 1.1
Fig. ( ) Methods used to overcome violence Fig. ( ) Methods used to overcome violence
N=142 n %
Talking with husband 43 30.2
Talking with neighbors 41 28.8
Pray and recite Quran 30 21.1
Nothing 25 17.6
Go to doctors 5 3.5
Take sedatives without consultation 3 2.1
Other variable studied with no significant Other variable studied with no significant difference difference
Smoking status, Smoking status,
residence,residence,
income, income,
husband occupation,husband occupation,
wife occupationwife occupation
Wife education,Wife education,
husband educationhusband education
ConclusionConclusion
75.9% of the studied females are exposed75.9% of the studied females are exposed Psychological violence is the highest formPsychological violence is the highest formIntimate partner control behavior correlated with Intimate partner control behavior correlated with
other recent study done in alexandriaother recent study done in alexandriaFinancial abuse is found as form of violenceFinancial abuse is found as form of violenceIncrease in exposure to violence with increasing age Increase in exposure to violence with increasing age
of husbandof husbandHusband addiction and presence of children were Husband addiction and presence of children were
highly associated with exposure to violence mainly highly associated with exposure to violence mainly physical violencephysical violence
Conclusion and recommendationConclusion and recommendation
Still the problem of domestic violence is a Still the problem of domestic violence is a silent epidemic and a neglected public silent epidemic and a neglected public health problem in Egypt. This complex health problem in Egypt. This complex problem needs more careful studies problem needs more careful studies especially qualitative studies to explore the especially qualitative studies to explore the deep rooted causes that can elaborate the deep rooted causes that can elaborate the effective measures to prevent this public effective measures to prevent this public health problem. health problem.
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