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Variability and validity of intimate partner violence reporting by couples in Tanzania.

ABSTRACT: In recent years, major global institutions have amplified their efforts to address intimate partner violence (IPV) against women-a global health and human rights violation affecting 15-71% of reproductive aged women over their lifetimes. Still, some scholars remain concerned about the validity of instruments used for IPV assessment in population-based studies. In this paper, we conducted two validation analyses using novel data from 450 women-men dyads across nine villages in Northern Tanzania. First, we examined the level of inter-partner agreement in reporting of men's physical, sexual, emotional and economic IPV against women in the last three and twelve months prior to the survey, ever in the relationship, and during pregnancy. Second, we conducted a convergent validity analysis to compare the relative efficacy of men's self-reports of perpetration and women's of victimization as a valid indicator of IPV against Tanzanian women using logistic regression models with village-level clustered errors. We found that, for every violence type across the recall periods of the last three months, the last twelve months and ever in the relationship, at least one in three couples disagreed about IPV occurrences in the relationship. Couples' agreement about physical, sexual and economic IPV during pregnancy was high with 86-93% of couples reporting concordantly. Also, men's self-reported perpetration had statistically significant associations with at least as many validated risk factors as had women's self-reported victimization. This finding suggests that men's self-reports are at least as valid as women's as an indicator of IPV against women in Northern Tanzania. We recommend more validation studies are conducted in low-income countries, and that data on relationship factors affecting IPV reports and reporting are made available along with data on IPV occurrences.

SUBMITTER: Halim N

PROVIDER: S-EPMC5843259 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Variability and validity of intimate partner violence reporting by couples in Tanzania.

Halim Nafisa N Steven Ester E Reich Naomi N Badi Lilian L Messersmith Lisa L

PloS one 20180308 3

In recent years, major global institutions have amplified their efforts to address intimate partner violence (IPV) against women-a global health and human rights violation affecting 15-71% of reproductive aged women over their lifetimes. Still, some scholars remain concerned about the validity of instruments used for IPV assessment in population-based studies. In this paper, we conducted two validation analyses using novel data from 450 women-men dyads across nine villages in Northern Tanzania. ...[more]

PMID: 29518162

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Project description:BackgroundIntimate partner violence (IPV) is a global problem that affects one-third of all women. The present study aims to develop and determine the validity of a screening instrument for the detection of IPV in pregnant women in Tanzania and Vietnam and to determine the minimum number of questions needed to identify IPV.MethodAn IPV screening instrument based on eight questions was tested on 1,116 Tanzanian and 1,309 Vietnamese women who attended antenatal care before 24 gestational weeks. The women were re-interviewed during their 30th-34th gestational week where the World Health Organization (WHO) IPV questionnaire was used as the gold standard. In all, 255 combinations of eight different questions were first tested on the Tanzanian study population where sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. In the evaluation of the performance of the question combinations, different IPV types and the frequency of abusive acts were considered. The question combinations that performed best in Tanzania were subsequently evaluated in the Vietnamese study population.ResultsIn Tanzania, a combination of three selected questions including one question on emotional IPV, one on physical IPV and one on sexual IPV was found to be most effective in identifying women who are exposed to at least one type of IPV during pregnancy (sensitivity = .80; specificity = .74). The performance of the identified combination was slightly less effective in Vietnam (sensitivity = .74; specificity = .68). Focusing on different IPV types, the best performance was found for exposure to physical IPV in both Tanzania (sensitivity = .93; specificity = .70) and Vietnam (sensitivity = .96; specificity = .55). In both countries, the sensitivity increased with the frequency of abuse whereas the specificity decreased.ConclusionBy asking pregnant women three simple questions we were able to identify women who were exposed to IPV during pregnancy in two different countries. The question combination performed best in assessing physical IPV where it identified 93% and 96% of Vietnamese and Tanzanian women, respectively, who were exposed to physical IPV.

Project description:BackgroundIntimate partner violence against women is a prevailing public health problem in Tanzania, where four of ten women have a lifetime exposure to physical or sexual violence by their male partners. To be able to suggest relevant and feasible community and health care based interventions, we explored community members' understanding and their responses to intimate partner violence.MethodsA qualitative study using focus group discussions with 75 men and women was conducted in a community setting of urban Tanzania. We analysed data using a grounded theory approach and relate our findings to the ecological framework of intimate partner violence.ResultsThe analysis resulted in one core category, "Moving from frustration to questioning traditional gender norms", that denoted a community in transition where the effects of intimate partner violence had started to fuel a wish for change. At the societal level, the category "Justified as part of male prestige" illustrates how masculinity prevails to justify violence. At the community level, the category "Viewed as discreditable and unfair" indicates community recognition of intimate partner violence as a human rights concern. At the relationship level, the category "Results in emotional entrapment" shows the shame and self-blame that is often the result of a violent relationship. At the individual level, the risk factors for intimate partner violence were primarily associated with male characteristics; the category "Fed up with passivity" emerged as an indication that community members also acknowledge their own responsibility for change in actions.ConclusionsPrevailing gender norms in Tanzania accept women's subordination and justify male violence towards women. At the individual level, an increasing openness makes it possible for women to report, ask for help, and become proactive in suggesting preventive measures. At the community level, there is an increased willingness to intervene but further consciousness-raising of the human rights perspective of violence, as well as actively engaging men. At the macro level, preventive efforts must be prioritized through re-enforcement of legal rights, and provision of adequate medical and social welfare services for both survivors and perpetrators.

Dataset Information

Variability and validity of intimate partner violence reporting by couples in Tanzania.

Publications

Variability and validity of intimate partner violence reporting by couples in Tanzania.

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