Public defence in health science: Hafijur Rahman

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Abstract

Background

Wife abuse is a pervasive global public health and human rights concern. This is also the case in Bangladesh. Rural women experience higher rates of wife abuse compared to their urban counterparts, but most interventions remain concentrated in urban areas. There is a lack of research exploring the gendered and ethnic dimensions of wife abuse in Bangladesh, and existing interventions have largely overlooked primary prevention strategies.

Aims

This thesis aimed to understand wife abuse and explore leaders’ experiences following a community-based educational intervention focusing on primary prevention and on supporting women in Bengali, Santal, and Garo communities in rural Bangladesh.

Methods

Studies I and II were cross-sectional, utilizing baseline survey data from 1929 married women and men. Data were collected via face-to-face interviews, using a structured questionnaire that included a revised version of the NorVold Abuse Questionnaire, the Social Acceptance of Wife Abuse scale, and the Women’s Social Mobility scale. Analysis included descriptive statistics, chi-square tests, and regression analyses. Study III was a qualitative study using six focus group discussions with 70 married women. Study IV was a qualitative follow-up study employing phone interviews with 13 community leaders. Data from Studies III and IV were analyzed using reflexive thematic analysis.

Findings

Study I revealed widespread exposure to different forms of abuse among married couples, with women being the primary victims. Garo women reported lower, and Garo men higher, prevalence of abuse by their spouse compared to the Bengali and Santal communities. Study II found that different types of wife abuse were widely accepted and positively associated with women’s low social mobility. Women, compared to men; and Bengalis and Santals, compared to Garos, reported higher acceptance of wife abuse. Study III highlighted women’s limited communication with natal family, friends, and neighbors after marriage, who are the key sources of informal support and keys in accessing formal support following wife abuse. Across all three communities, immense structural and practical barriers pertaining to patriarchy hindered women’s ability to seek support. Study IV showed that the community-based educational intervention provided leaders with valuable insights, initiated attitudinal and behavioral changes among them, and fostered their involvement in increasing people’s awareness, victim support, and collaboration with service providers to prevent and reduce wife abuse.

Conclusion

This thesis identifies gender and ethnic differences of wife abuse and highlights the barriers that keep women from seeking support. It also demonstrates the promising potential of a community-based educational interventions to support victims of wife abuse in rural Bangladesh.

Keywords: Gender, ethnicity, wife abuse, community, intervention, EEEE, rural, Bangladesh.