Studies indicate an association of undernutrition amongst children in households having domestic violence, writes Shoba Suri. Photo for representation: Shutterstock

According to the World Health Organization (WHO), around 736 million women worldwide are “devastatingly widespread” violence against women. Women from low- and low-middle-income countries are disproportionately affected by violence. About 37 percent of women (15 to 49 years old) in the poorest countries are victims of violence, with domestic violence prevalent in South Asia and sub-Saharan Africa (Figure 1). The lowest prevalence (16-23 percent) was observed in the Europe, Central, and East Asia regions.

The pandemic has exacerbated violence against women, with domestic violence in particular increasing. The reasons are stress with loss of livelihood, disruption of social and protective networks, tight living conditions and restricted freedom of movement. The Sustainable Development Goal (SDG) for gender equality calls for the elimination of “all forms of violence against all women and girls in the public and private sectors, including human trafficking and sexual and other forms of exploitation”. However, 49 countries have no domestic violence legislation. The effects of COVID-19 have led to a 30 percent increase in domestic violence in some countries.

Violence has a direct impact on women’s health – physical, sexual and reproductive, as well as mental and behavioral. It increases the risk of maternal mortality and its pregnancy-related consequences – low maternal weight and stillbirths. Studies in different countries – Nicaragua, Bangladesh, India, and the United States – report a high incidence of low birth weight babies and deaths in pregnant women from domestic violence.

The WHO conducted a cross-country study on women’s health and domestic violence against women, which showed a strong link between violence and physical and mental illness symptoms in women. Women exposed to domestic violence are 16 percent more likely to have a low birth weight baby. Domestic violence not only affects women directly, it also affects children. Studies suggest an association with child malnutrition in households with domestic violence. A review of population and health surveys from 29 low- and middle-income countries showed a strong association between stunted growth and domestic violence among both rich and low-educated women. The effects of domestic violence are further masked by the effects of food insecurity, micronutrient deficiencies and limited access to sanitation in poor households.

Evidence from Latin America on domestic violence and child feeding suggests negative effects on a child’s long-term nutritional status. The child is less likely to receive prenatal care and breastfeeding and vaccination. A causal estimate of the intangible costs of violence against women in Latin America and the Caribbean suggests a negative association with women’s health, affecting both short-term health outcomes and child human capital accumulation.

However, women’s education and age tend to protect against the negative effects of violence on children’s health. The World Bank states that violence against women could cost up to 3.7 percent of GDP. Studies from Bangladesh and Nepal show a connection between violence and the nutritional status of women and a possible connection with increased stress, poor self-care and nutrition. A study of mother-child dyads from Pakistan shows a significant increase in underweight, stunted and exhausted children among women exposed to domestic violence.

Results from a health demographic survey in Bangladesh show that children of women who have been subjected to lifelong domestic violence have stunted growth at a higher risk of stunted growth. Joint studies from Nicaragua and Bangladesh suggest that the improved status of women is strongly linked to improvements in the health and nutritional status of children. A regression analysis of data from Bangladesh found, among other things, domestic violence as a risk factor contributing to stunted growth in children. The effects of violence against women last for generations and lead to serious demographic consequences that impair educational and earning opportunities.

There is a growing concern about gender-based violence in India, which has significant economic and social costs. Previous surveys indicate an increasing trend of domestic violence in India despite being a criminal offense under Section 498-A of the Indian Criminal Code. One study suggests an increased likelihood of stunted growth, underweight and emaciation in children whose mothers have experienced spouse violence. Results of NFHS-5 data for 2019-20 show a decrease in the rate of spousal violence in many states and union territories (Figure 2). However, Karnataka, Assam, Maharashtra, Ladakh, Sikkim and Himachal Pradesh show increasing trends.

Atreyee Sinha and Aparajita Chattopadhyay used a conceptual framework to work out the connection between marital violence and the nutritional status of children (Figure 3). It relates to how children’s health depends on self-determination and the state of health of the mother, and that marriage violence is an important intermediate factor affecting children’s health.

There is evidence of a direct causal relationship between domestic violence and child growth and development, with significant effects on stunted growth and child underweight.

The effects of violence are more pronounced in inactive women than in employed and empowered women. Domestic violence is a human rights issue and reducing its incidence contributes to the resulting health benefits. In particular, the pandemic has increased the challenge for teenage girls (10-19 years old) in accessing basic services. The social and economic impact of COVID-19 is profound for rural women who continue to face domestic violence, abuse and malnutrition. Similar results have been reported by rural and indigenous communities in southern India.

Improving gender inequality could help reduce the rate of stunted growth in children by 10 percentage points. The combination of nutrition-specific interventions with measures to empower women is also indispensable and indispensable for reducing child malnutrition. A randomized controlled trial in Mumbai’s slums suggests community mobilization to address the public health burden of violence against women and girls. Systemic review of domestic violence reduction interventions requires effective communication-based and community-based interventions.

There is an urgent need for stepped up intervention and investment in reducing malnutrition, improving nutrition and education for women, promoting gender equality, empowering women and eradicating domestic violence against women to reduce the prevalence of malnutrition .

This article was published for the first time on ORF.

Disclaimer:Dr. Shoba Suri is a Senior Fellow of the ORF Health Initiative. She is a nutritionist with experience in community and clinical research. Views expressed are personal.

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