Health consequences of domestic violence against women in Serbia

Vesna Mijatović Jovanović; Sonja Čanković; Dragana Milijašević; Snežana Ukropina; Mladen Jovanović; Dušan Čanković

doi:10.2298/VSP171130054M

Vesna Mijatović Jovanović University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Sonja Čanković University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Dragana Milijašević Institute of Public Health of Vojvodina, Center for Analysis, Planning and Organization of Health Care, Novi Sad, Serbia
Snežana Ukropina University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Mladen Jovanović University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Dušan Čanković University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP171130054M

Keywords: battered women, domestic violence, health, risk factors, socioeconomic factors, women

Abstract

Background/Aim. Domestic violence against women is a significant public health problem resulting in serious health and social consequences, for women and their families. The aim of this study was to analyze the sociodemographic characteristic of women who were exposed to domestic violence, as well as the impact of violence on women's health. Methods. Data from cross-sectional study from the 2013 National Health Survey in Serbia were used analyzing 6,320 women aged 20–75 years. Univariate and multivariate logistic regression analyses were implemented to assess the association of exposure to domestic violence against women with sociodemographic characteristics, as well as with selected health indicators and health risk behaviors. Results. Out of total number of examined women, 307 (4.9%) reported that they experienced physical and/or psychological violence in the last 12 months. Divorced or separated women, poor women and women with poor social support had greater odds for exposure to domestic violence. Women who had experienced domestic violence were less likely to perceived their health as good than women who had not experienced domestic violence [adjusted odds ratio (AOR) = 0.47; 95% confidence interval (CI) = 0.32–0.71], and more likely to report severe or very severe pain (AOR = 2.41; 95% CI = 1.74–3.33), stress and pressure exposure (AOR = 2.62; 95% CI = 1.89–3.64) and depression (AOR = 3.24; 95% CI = 2.08–5.03). Exposure to violence was also associated with the use of sleeping pills or sedative (AOR = 2.21; 95% CI = 1.67–2.93), with frequent use of alcohol (AOR = 1.42; 95% CI = 1.08–1.86) and abortion (AOR = 3.11; 95% CI = 1.48–6.54). Conclusion. Women, victims of domestic violence are more likely to have physical and mental disorders compared to women who are not victims of domestic violence. Violence prevention demands a multi-sectoral approach, in which the health sector has a central role that includes early identification and recognition of abuse, appropriate care as well as documenting and reporting violence.

References

World Health Organization. Global and regional estimates of vi-olence against women: prevalence and health effects of inti-mate partner violence and nonpartner sexual violence. Gene-va: World Health Organization; 2013.

Council of Europe. Convention on Preventing and Combating Violence against Women and Domestic Violence; Istanbul, 11. V 2011. [cited 2017 Apr 19]. Available from: http:// https://rm.coe.int/168008482e

Flury M, Nyberg E, Riecher-Rössler A. Domestic violence against women: Definitions, epidemiology, risk factors and consequences. Swiss Med Wkly 2010; 140: w13099.

Ministry of Health Republic of Serbia. Special Protocol for The Protection and Treatment of Women Victims of Violence. Belgrade; 2010. [cited 2017 Apr 27]. Available from:

http://www.zdravlje.gov.rs/downloads/Zakoni/Ostalo/ProtokolMZRSZaZastituIPostupanjeSaZenamaKojeS-uIzlozeneNasilju.pdf (Serbian)

World Health Organization. Global status report on violence prevention 2014. Geneva: World Health Organization; 2014.

Krantz G, Garcia - Moreno C. Violence against women. J Epi-demiol Community Health 2005; 59(10): 818–21.

Azhar Z, Sohail M M, Yasin G, Mahmood B, Mushtaq SK. Ex-ploring socio-economic factors behind domestic violence against women in Sargodha district. Int J Asian Soc Sci 2012; 2(9): 1617–26.

Kishor S, Johnson K. Profiling Domestic Violence – A Multi-Country Study. Calverton, Maryland: ORC Macro; 2004.

Babović M, Ginić K, Vuković O. Mapping family violence in cen-tral Serbia. Belgrade: SeConS; 2010. (Serbian)

World Health Organization. Multi-country study on women’s health and domestic violence against women: Summary report of initial results on prevalence, health outcomes and women’s responses. Geneva: World Health Organization; 2005.

Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C. WHO Multi-country Study on Women's Health and Do-mestic Violence against Women Study Team. Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic vio-lence: an observational study. Lancet 2008; 371(9619): 1165–72.

Coker AL, Davis KE, Arias I, Desai S, Sanderson M, Brandt HM, et al. Physical and mental health effects of intimate part-ner violence for men and women. Am J Prev Med 2002; 23(4): 260–8.

Otašević S. Violence in intimate partner relationships and health. Belgrade: Autonomous Women Center; 2005. (Serbi-an)

Al Dosary AH. Health impact of domestic violence against Saudi women: Cross Sectional Study. Int J Health Sci (Qas-sim) 2016; 10(2): 165–73.

Trinh OT, Oh J, Choi S, To KG, Van Do D. Changes and socio-economic factors associated with attitudes towards domestic violence among Vietnamese women aged 15-49: findings from the Multiple Indicator Cluster Surveys, 2006-2011. Glob Health Action 2016; 9(1): 29577.

The Institute of Public Health of Serbia ”Dr Milan Jovanović Batut“. Results of the National Health Survey of the Republic of Ser-bia 2013. Belgrade: Official Gazette; 2014

Rutstein SO, Johnson K. The DHS Wealth Index. DHS Compar-ative Reports No. 6. Calverton, Maryland, USA: ORC Macro; 2004.

Bøen H, Dalgard OS, Bjertness E. The importance of social sup-port in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home: a cross sectional study. BMC Ger-iatr 2012; 12: 27.

Kroenke K, Strine TW, Spitzer RL, Williams JB, Berry JT, Mokdad AH. The PHQ-8 as a measure of current depression in the general population. J Affect Disord 2009; 114(1–3): 163–73.

Djikanovic B, King EJ, Bjegovic-Mikanovic V. Gender Differences in Health Symptoms Associated with the Exposure to Physical Violence in Family: Data from the 2006 National Health Sur-vey in Serbia. J Fam Viol 2013; 28: 753–61.

European Union Agency for Fundamental Rights. Violence against Women: an EU-wide survey. Main results. Luxembourg: Pub-lications Office of the European Union; 2014.

Pallitto CC, García-Moreno C, Jansen HA, Heise L, Ellsberg M, Watts C. WHO Multi-Country Study on Women's Health and Domestic Violence. Intimate partner violence, abortion, and unintended pregnancy: results from the WHO Multi-country Study on Women's Health and Domestic Violence. Int J Gynaecol Obstet 2013; 120(1): 3–9.

Coker AL, Smith PH, Bethea L, King MR, McKeown RE. Physi-cal health consequences of physical and psychological intimate partner violence. Arch Fam Med 2000; 9(5): 451–7.

Nybergh L, Taft C, Enander V, Krantz G. Self-reported expo-sure to intimate partner violence among women and men in Sweden: results from a population-based survey. BMC Public Health 2013; 13: 845.

Tetikcok R, Ozer E, Cakir L, Enginyurt O, İscanli MD, Cankaya S, et al. Violence towards women is a public health problem. J Forensic Leg Med 2016; 44: 150–7.

Abramsky T, Watts C, Garcia-Moreno C, Devries K, Kiss L, Ells-berg M, et al. What factors are associated with recent intimate partner violence? Findings from the WHO multi-country study on women’s health and domestic violence. BMC Public Health 2011; 11: 109.

Mavrikiou PM, Apostolidou M, Parlalis SK. Risk factors for the prevalence of domestic violence against women in Cyprus. Soc Sci J 2014; 51(2) :295–301.

Owusu Adjah ES, Agbemafle I. Determinants of domestic vio-lence against women in Ghana. BMC Public Health 2016; 16: 368.

Djikanovic B, Jansen HA, Otasevic S. Factors associated with in-timate partner violence against women in Serbia: a cross sec-tional study. J Epidemiol Community Health 2010; 64(8): 728–35.

Ferrari G, Agnew-Davies R, Bailey J, Howard L, Howarth E, Peters TJ, et al. Domestic violence and mental health: a cross-sectional survey of women seeking help from domestic vio-lence support services. Glob Health Action 2016; 9(1): 29890.

Centers for Disease Control and Prevention (CDC). Adverse health conditions and health risk behaviors associated with intimate partner violence-United States, 2005. MMWR Morb Mortal Wkly Rep 2008; 57(5): 113–7.

Macy RJ, Ferron J, Crosby C. Partner violence and survivors' chronic health problems: informing social work practice. Soc Work 2009; 54(1): 29–43.

Carbone-López K, Kruttschnitt C,Macmillan R. Patterns of inti-mate partner violence and their associations with physical health, psychological distress, and substance use. Public Health Rep 2006; 121(4): 382–92.

Rees S, Silove D, Chey T, Ivancic L, Steel Z, Creamer M, et al. Lifetime prevalence of gender-based violence in women and the relationship with mental disorders and psychosocial func-tion. JAMA 2011; 306(5): 513–21.

Machisa MT, Christofides N, Jewkes R. Mental ill health in struc-tural pathways to women's experiences of intimate partner vi-olence. PLoS ONE 2017; 12(4): e0175240.

Reingle JM, Jennings WG, Connell NM, Businelle MS, Chartier K. On the pervasiveness of event-specific alcohol use, general substance use, and mental health problems as risk factors for intimate partner violence. J Interpers Violence 2014; 29(16): 2951–70.

Devries KM, Child JC, Bacchus LJ, Mak J, Falder G, Graham K, et al. Intimate partner violence victimization and alcohol con-sumption in women: a systematic review and meta-analysis. Addiction 2014; 109(3): 379–91.

The Law on Prevention of Domestic Violence. Official Herald of the RS, No. 94/2016. (Serbian)