Determinants and Reproductive Health Consequences of Domestic Violence in India

描述（由申请人提供）：家庭暴力是全球妇女经历的最普遍的暴力形式。尽管在过去十年中对这一问题的关注有所增加，但在发展中国家，对这一问题的诱发因素及其对妇女生殖健康和心理健康的影响的了解仍然有限。这一建议建立在调查人员以前为进一步探讨印度农村家庭暴力的决定因素和后果而开展的方法和实质性工作的基础上，印度农村的特点是家庭暴力发生率高，妇女生殖健康和精神健康状况差。这项研究的定量数据来自2002-03年对6437名育龄妇女进行的一项后续研究的面板数据，这些妇女最初是作为1998-99年全国家庭健康调查的一部分在印度四个邦--比哈尔邦、贾坎德邦、马哈拉施特拉邦和泰米尔纳德邦--进行采访的，并辅之以地区一级的犯罪数据。将采用多层次logit模型来调查个人层次（社会经济地位、人口因素、妇女地位、家庭结构、嫁妆充足性、饮酒量、家庭暴力代际暴露）和背景因素（社会经济发展、妇女地位、暴力犯罪率、家庭暴力规范）在解释这种情况下家庭暴力风险方面的相对贡献。随后，该研究将采用伽马脆弱模型，利用研究的前瞻性和回顾性数据，调查家庭暴力与出生结果、选定的生殖健康结果（避孕药具采用、意外怀孕）和妇女心理健康之间的关系。这项研究的结果将使人们对印度等资源匮乏地区家庭暴力的诱发因素有新的认识，并提出可能的个人和社区干预措施，以减少妇女遭受这种暴力的风险。我们的研究结果还可能突出家庭暴力对公共卫生的重要性，提供更多关于家庭暴力对儿童生存和妇女生殖及心理健康和福祉的影响的结论性证据。

DESCRIPTION (provided by applicant): Domestic violence represents the most pervasive form of violence which women experience globally. Despite increased attention to this issue over the last decade, understanding of its precipitating factors and consequences for women's reproductive and mental health remains limited in developing countries. This proposal builds upon previous methodological and substantive work by the investigators to further explore the determinants and consequences of domestic violence in rural India, a setting characterized by high rates of domestic violence and poor reproductive and mental health among women. Quantitative data for the study come from panel data from a 2002-03 follow-up study of 6437 reproductive-aged women originally interviewed as part of the 1998-99 National Family Health Survey-2 in four Indian states-Bihar, Jharkhand, Maharashtra, and Tamil Nadu-- supplemented by district-level crime data. Multi-level logit models will be employed to investigate the relative contributions of individual-level (socioeconomic status, demographic factors, women's status, family structure, dowry adequacy, alcohol consumption, intergenerational exposure to domestic violence) and contextual (socioeconomic development, women's status, violent crime rates, norms concerning domestic violence) factors in explaining the risk of domestic violence in this setting. The study will subsequently employ gamma frailty models to investigate the relationship between domestic violence and birth outcomes, selected reproductive health outcomes (contraceptive adoption, unintended pregnancy), and women's mental health using both prospective and retrospective data from the study. Findings from the study will yield new insights into the precipitating factors for domestic violence in low resource settings such as India, and suggest potential individual- and community-level interventions to reduce the risks of such violence to women. Our findings are also likely to highlight the public health significance of domestic violence, by providing more conclusive evidence on the implications of domestic violence for child survival and women's reproductive and mental health and well-being.