Prevalence and predictors of help-seeking for women exposed to spousal violence in India – a cross-sectional study

This article summarises findings from ten countries from the WHO multi-country study on women's health and domestic violence against women. Standardised population-based surveys were done between 2000 and 2003. Women aged 15-49 years were interviewed about their experiences of physically and sexually violent acts by a current or former intimate male partner, and about selected symptoms associated with physical and mental health. The women reporting physical violence by a partner were asked about injuries that resulted from this type of violence. 24,097 women completed interviews. Pooled analysis of all sites found significant associations between lifetime experiences of partner violence and self-reported poor health (odds ratio 1.6 [95% CI 1.5-1.8]), and with specific health problems in the previous 4 weeks: difficulty walking (1.6 [1.5-1.8]), difficulty with daily activities (1.6 [1.5-1.8]), pain (1.6 [1.5-1.7]), memory loss (1.8 [1.6-2.0]), dizziness (1.7 [1.6-1.8]), and vaginal discharge (1.8 [1.7-2.0]). For all settings combined, women who reported partner violence at least once in their life reported significantly more emotional distress, suicidal thoughts (2.9 [2.7-3.2]), and suicidal attempts (3.8 [3.3-4.5]), than non-abused women. These significant associations were maintained in almost all of the sites. Between 19% and 55% of women who had ever been physically abused by their partner were ever injured. In addition to being a breach of human rights, intimate partner violence is associated with serious public-health consequences that should be addressed in national and global health policies and programmes.

This paper suggests a conceptual framework for understanding the processes of help-seeking among survivors of intimate partner violence (IPV). A cognitive theory from general literature on help-seeking in "stigmatizing" situations suggests three relevant processes or stages of seeking help in the IPV context: defining the problem, deciding to seek help, and selecting a source of support. Individual, interpersonal, and sociocultural factors that influence decision-making at each of these stages are discussed and illustrated with case examples.

Attitudes toward men's violence against women shape both the perpetration of violence against women and responses to this violence by the victim and others around her. For these reasons, attitudes are the target of violence-prevention campaigns. To improve understanding of the determinants of violence against women and to aid the development of violence-prevention efforts, this article reviews the factors that shape attitudes toward violence against women. It offers a framework with which to comprehend the complex array of influences on attitudes toward violent behavior perpetrated by men against women. Two clusters of factors, associated with gender and culture, have an influence at multiple levels of the social order on attitudes regarding violence. Further factors operate at individual, organizational, communal, or societal levels in particular, although their influence may overlap across multiple levels. This article concludes with recommendations regarding efforts to improve attitudes toward violence against women.