Spousal violence against women in Pakistan: Implications for women's health

Introduction: Spousal violence (SV) is widely prevalent and largely underreported in Pakistan because of various cultural and structural reasons. The negative health impacts of violence are well-documented world-wide, but very few studies are available about Pakistan. The aim of this study was to determine the prevalence of SV in two cities of Pakistan as well as to assess its association with socio-demographic variables and its consequences for women's health. Methods: Quantitative data were collected from randomly selected eight hospitals of Lahore and Sialkot. From these hospitals, 373 ever-married women of reproductive ages (16–49) were randomly selected for collecting information through a structured interview schedule. Multivariable logistic regression was performed to assess the association between socio-demographic variables and all three types of violence.In order to discern the impact of psychological, physical and sexual violence on health, violence was categorised as „minor“ and „severe“ and women who experienced severe violence were compared to all others with respect to mental and reproductive health. Mental and reproductive health outcomes were measured by standardised scales. Results: About 75.9% women reported severe psychological violence followed by severe physical (31.9%) and sexual (34.6%) violence at least once in their marital life. Women with lower family income (Adjusted odds ratio [AOR] 1.76, 95%confidence interval [95% CI] 1.01–3.08), lower level of education (AOR 2.51, 95% CI 1.12–5.59), and married without their consent (AOR 1.46, 95% CI 1.00–3.01) were more likely to report severe physical violence. Similar associations existed for other types of violence. All types of violence were negatively associated with mental health (p<0.001, ANOVA) as well as with the reproductive health (p<0.001) of the victims. Conclusions: Study highlighted the magnitude of violence and its consequential health outcomes for women. The situation calls for an urgent action to mitigate the violence-induced damages done to general