Intimate partner violence against women with disability and associated mental health concerns: a cross-sectional survey in Mumbai, India

Abstract

ObjectivesThe risk of intimate partner violence (IPV) against women with disability is believed to be high. We aimed to compare the prevalence of past-year IPV against women with and without functional difficulties in urban informal settlements, to review its social determinants and to explore its association with mental health.DesignCross-sectional survey.SettingFifty clusters within four informal settlements.Participants5122 women aged 18–49 years.Primary and secondary outcome measuresWe used the Washington Group Short Set of Questions to assess functional difficulties. IPV in the past year was described by binary composites of questions about physical, sexual and emotional violence. We screened for symptoms of depression using the Patient Health Questionnaire-9 and of anxiety using the Generalised Anxiety Disorder-7. Multivariable logistic regression models examined associations between functional difficulties, IPV and mental health.Results10% of participants who screened positive for functional disability had greater odds of experiencing physical or sexual IPV (adjusted OR (AOR) 1.68, 95% CI 1.23 to 2.29) and emotional IPV (1.52, 95% CI 1.16 to 2.00) than women who screened negative. Women who screened positive for functional disability had greater odds than women who screened negative of symptoms suggesting moderate or severe anxiety (AOR 2.50, 95% CI 1.78 to 3.49), depression (2.91, 95% CI 2.13 to 3.99) and suicidal thinking (AOR 1.94, 95% CI 1.50 to 2.50).ConclusionsThe burden of IPV fell disproportionately on women with functional difficulties, who were also more likely to screen positive for common mental disorder. Public health initiatives need to respond at local and national levels to address the overlapping and mutually reinforcing determinants of violence, while existing policy needs to be better utilised to ensure protection for the most vulnerable.

Socio-Ecological Determinants of Attitudes Towards Domestic Violence Among Iraqi Women: Where Are the Most Vulnerable?

“…For the individual level factors, married women with functional difficulty were found to have a higher likelihood of accepting domestic violence. This finding aligns with previous literature [44][45][46] emphasizing the double vulnerability of women with functional difficulty and their acceptance to domestic violence. It is important to note that approximately 10% of the Iraqi population live with one or more disabilities, with nearly two million of them being women of reproductive age [47].…”

“…This was determined using a set of questions focused on six domains: seeing, hearing, walking, self-care, communication, and remembering. If a woman experienced any of these difficulties, it was classified as (yes) for functional difficulties; Otherwise, it was classified as (no) [43]. Additionally, Exposure to mass media had been created based on reading a newspaper, listening to the radio, or watching television.…”

Association Between Disabilities, Educational Attainment, Literacy, and Intimate Partner Violence: Findings from the Indian National Family Health Surveys

“…As noted above, research suggests extent frameworks may not be applicable outside of the western context they were developed in (Hayes et al, 2021 ; VanderEnde et al, 2012 ). Among the few studies which have examined IPV risk among persons with disabilities in India, Riley and colleagues ( 2022 ) found that those with disabilities within Mumbai had a greater risk of IPV. This item was nevertheless limited to disability in general (i.e., yes/no disability).…”

“…This sensory difference may exacerbate risk of IPV for Blind respondents. Collectively, these items allow us to explore IPV vulnerability among marginalized women who may not experience such severe disabilities that they are institutionalized (Human Rights Watch, 2014 ) but who nonetheless may be at greater risk (Breiding & Armour, 2015 ; Riley et al, 2022 ).…”

“…While there is a growing body of literature on IPV in India in general (e.g., Das & Roy, 2020 ; Dutta et al, 2016 ; Mondal & Paul, 2021a ), another emerging area suggests that Indian women with disabilities may be more vulnerable to IPV (Riley et al, 2022 ). This is cause of concern given Human Rights Watch ( 2014 ) called attention to the institutionalization and forced treatment of Indian women with disabilities.…”