Journal of Family Violence

, Volume 31, Issue 1, pp 15–25 | Cite as

Domestic Violence Against Rural Women in Pakistan: An Issue of Health and Human Rights

  • Rubeena Zakar
  • Muhammad Z. Zakar
  • Safdar Abbas
Original Article


Pakistani women living in rural areas are particularly vulnerable to violence because of their relatively weaker social position and lack of awareness about their legal rights. We investigated domestic violence against rural women and its association with women’s health. A cross-sectional survey was conducted from Rural Health Center of five selected districts by conducting face-to-face interviews from 490 randomly selected women of reproductive age. The data showed that about 65 % of the interviewed women had experienced different types of violence, with psychological violence being the most common. Multivariate logistic regression analysis showed that women’s low education, low income, and marriage at an early age were significantly associated with domestic violence. Additionally, Domestic violence was significantly associated with poor mental and reproductive health. These findings may be useful in developing public health programs to address domestic violence against rural women.


Human rights violation Women’s mental health Psychological violence Risk factors for domestic violence 


  1. Alam, A. Y., Qureshi, A. A., Adil, M. M., & Ali, H. (2014). Factors affecting utilization of antenatal care among women in urban slum areas of Islamabad. Rawal Medical Journal, 39(2), 71–75.Google Scholar
  2. Ali, P. A., & Gavino, M. I. (2008). Violence against women in Pakistan: A framework for analysis. Journal of Pakistan Medical Association, 58(4), 198–203.Google Scholar
  3. Amado, L. E. (2003). Sexually and bodily rights as human rights in the Middle East and North Africa. A Workshop Report, Malta. Women for Women’s human rights: New Ways and Meditarian Academy of Diplomatic Studies.Google Scholar
  4. Ashwin, S., & Lytkina, T. (2004). Men in crisis in Russia: the role of domestic marginalization. Gender and Society, 18, 189–206.CrossRefGoogle Scholar
  5. Ayub, M., Irfan, M., Nasr, T., Lutufullah, M., Kingdon, D., & Naeem, F. (2009). Psychiatric morbidity and domestic violence: a survey of married women in Lahore. Social Psychiatry and Psychiatric Epidemiology, 44(11), 953–60.PubMedCrossRefGoogle Scholar
  6. Basile, K. C., Arias, I., Desai, S., & Thompson, M. P. (2004). The differential association of intimate partner physical, sexual, psychological, and stalking violence and posttraumatic stress symptoms in a nationally representative sample of women. Journal of Traumatic Stress, 17(5), 413–21.PubMedCrossRefGoogle Scholar
  7. Bernston, E. (1993). Farm stress: Its economic dimension, its human consequences. Standing Senate Committee on Agriculture and Forestry. Canada. Retrieved July 14, 2012, from
  8. Bogal-Allbritten, R., & Daughaday, L. R. (1990). Spouse abuse program services: a rural urban comparison. Human Services Rural Environment, 14(2), 6–10.Google Scholar
  9. Campbell, J. C. (2002). Health consequences of intimate partner violence. The Lancet, 359, 1331–36.CrossRefGoogle Scholar
  10. Coker, A. L. (2007). Does physical intimate partner violence affect sexual health? A systematic review. Trauma, Violence & Abuse, 8(2), 149–160.CrossRefGoogle Scholar
  11. Coker, A. L., Flerx, V. C., Smith, P. H., Whitaker, D. J., Fadden, M. K., & Williams, M. (2007). Partner violence screening in rural health care clinics. American Journal of Public Health, 97(7), 1319–25.PubMedPubMedCentralCrossRefGoogle Scholar
  12. Cripe, S. M., Sanchez, S. E., Perales, M. T., Lam, N., Garcia, P., & Williams, M. A. (2008). Association of intimate partner physical and sexual violence with unintended pregnancy among pregnant women in Peru. International Journal of Gynecology and Obstetrics, 100, 104–108.PubMedCrossRefGoogle Scholar
  13. Critelli, F. M. (2010). Women’s rights=human rights: Pakistani women against gender violence. Journal of Sociology and Social Welfare, 37(2), 135–160.Google Scholar
  14. Diop-Sidibé, N., Campbell, J. C., & Becker, S. (2006). Domestic violence against women in Egypt-wife beating and health outcomes. Social Science and Medicine, 62(5), 1260–1271.Google Scholar
  15. Fatmi, Z., & Avan, B. (2002). Demographic, socio-economic and environmental determinants of utilization of antenatal care in a rural setting of Sindh, Pakistan. Journal of Pakistan Medical Association, 138–42.Google Scholar
  16. Fikree, F. F., & Bhatti, L. I. (1999). Domestic violence and health of Pakistani women. International Journal of Gynecology & Obstetrics, 65, 195–201.CrossRefGoogle Scholar
  17. Fikree, F. F., Khan, A., Kadir, M. M., Sajan, F., & Rahbar, M. H. (2001). What influences contraceptive use among young women in urban squatter settlement of Karachi, Pakistan? International Family Planning Perspectives, 27(3), 130–136.CrossRefGoogle Scholar
  18. Finlayson, K., & Downe, S. (2013) Why Do women not use aAntenatal Services in Low- and Middle-Income Countries? A Meta-Synthesis of Qualitative Studies. PLoS Med 10(1): e1001373. doi: 10.1371/journal.pmed.1001373.
  19. Frohmader, C., & Ortoleva, S. (2013). The sexual and reproductive rights of women and girls with disabilities. Retrieved December 14, 2014, from Women enabled:
  20. Garcia-Moreno, C., Jansen, H. A. F. M., Ellsberg, M., Heise, L. L., & Watts, C. H. (2005). WHO,multicounty study on women’s health and domestic violence against women: initials results on prevalence, health outcomes, and women’s responses. Switzerland: World Health Organization.Google Scholar
  21. Gazmararian, J. A., Petersen, R., Spitz, A. M., Goodwin, M. M., Saltzman, L. E., & Markes, J. S. (2000). Violence and reproductive health: current knowledge and future research directions. Maternal and Child Health Journal, 4, 79–84.PubMedCrossRefGoogle Scholar
  22. Government of the Punjab. (2012). Punjab portal. Retrieved from Rural Health Centers:
  23. Gracia, E., & Herrero, J. (2006). Acceptability of domestic violence against women in the European Union: a multilevel analysis. Journal of Epidemiology & Community Health, 123–9.Google Scholar
  24. Hall, M., Chappell, L. C., Parnell, B. L., Seed, P. T., Bewley, S. (2014). Associations between intimate partner violence and termination of pregnancy: A systematic review and meta-analysis. PLOS Medicine.Google Scholar
  25. Hausmann, R., Tyson, L. D., & Zahidi, S. (2013). The Global gender gap report. Geneva: World Economic Forum. Retrieved from
  26. Health Department. (2010–13). Three years rolling plan (All Districts). Retrieved January 12, 2014, from Punjab Health Sector Reforms Programme:
  27. Heise, L., Ellsberg, M., Gottemmoeller. (1999). Ending violence against women. population reports, series L, no. 11. Baltimore, MD: Population Information Program, Center for Communication Programs, the Johns Hopkins University School of Public Health, Population Information Program (Population Reports, Series L, no. 11). Retrieved from:
  28. Hidrobo, M., & Fernald, L. (2013). Major health and human rights problem. Journal of Health Economics, 32(1), 304–319.PubMedCrossRefGoogle Scholar
  29. Hindin, M. J., & Adair, L. S. (2002). Who is at risk? Factors associated with intimate partner. Social Science Medicine, 55(8), 1385–99.PubMedCrossRefGoogle Scholar
  30. HRCP. (2012). State of human rights in 2012. Lahore: Human Rights Commission of Pakistan.Google Scholar
  31. ICRW. (2006). Child marriage and domestic violence. Retrieved March 21, 2014, from
  32. Jejeebhoy, S. (1998). Wife-beating in rural India: a husband’s right? Economic and Political Weekly, 11(1998), 855–862.Google Scholar
  33. Kazi, S., Reeves, M., Creinin, M. (2008). The prevalence of domestic violence in volunteers for abortion and contraceptive research studies. Contraception, 79–83.Google Scholar
  34. Khodarahimi, S. (2014). Role of family violence on mental health and hopefulness in an Iranian adolescents sample. Journal of Family Violence, 259–268.Google Scholar
  35. Koenig, M. A., Ahmed, S., Hossain, M., Mozumder, A., & Khorshed, A. (2003). Women’s status and domestic violence in rural Bangladesh: individual- and community-level effects. Demography, 40(2), 269–88.PubMedCrossRefGoogle Scholar
  36. Krishnan, S. P., Hilbert, J. C., & Vanleeuwen, D. (2001). Domestic violence and help-seeking behavior among rural women: results from a shelter-based study. Family Community Health, 24, 28–38.PubMedCrossRefGoogle Scholar
  37. Kumar, S., Jeyaseelan, L., Suresh, S., & Ahuja, R. C. (2005). Domestic violence and its mental health correlates in Indian women. British Journal of Psychiatry, 187, 62–67.PubMedCrossRefGoogle Scholar
  38. Moore, A. M., Frohwirth, L., & Miller, E. (2010). Male reproductive control of women who have experienced intimate partner violence in the United States. Social Sciences and Medicine, 70(11), 1737–1744.CrossRefGoogle Scholar
  39. Mumtaz, Z., & Salway, S. M. (2007). Gender, pregnancy and the uptake of antenatal care services in Pakistan. Sociology of Health and Illness, 29(1), 1–26.PubMedCrossRefGoogle Scholar
  40. Nasrullah, M., Zakar, R., Zakar, M. Z. (2014). Child marriage and its associations with controlling behaviors and spousal violence against adolescent and young women in Pakistan. Journal of Adolescent Health, 804–809.Google Scholar
  41. National Institute of Population Studies and Macro International. (2013). Pakistan demographic and health survey 2012–13. Islamabad: National Institute of Population Studies and Macro International.Google Scholar
  42. Niaz, U. (2003). Violence against women in South Asian countries. Archives of Women’s Mental Health, 6, 173–184.PubMedCrossRefGoogle Scholar
  43. Pallitto, C. C., Campbell, J. C., & O’Campo, P. (2005). Is intimate partner violence associated with unintended pregnancy: a review of the literature? Trauma Violence and Abuse, 6(3), 217–235.CrossRefGoogle Scholar
  44. Peek-Asa, C., Wallis, A., Harland, K., Beyer, K., Dickey, P., & Saftlas, A. (2011). Rural disparity in domestic violence prevalence and access to resources. Journal of Womens Health, 20(11), 1743–9.Google Scholar
  45. Raj, A., Saggurt, N., Balaiah, D., & Silverman, J. G. (2009). Prevalence of child marriage and its impact on the fertility and fertility control behaviors of young women in India. Lancet, 1883–1889.Google Scholar
  46. Riddell, T., Ford-Gilboe, M., Leipert, B. (2009). Strategies used by rural women to stop, avoid, or escape from intimate partner violence. Health Care Women Int, 134–159.Google Scholar
  47. Roy, M. P., Mohan, U., Singh, S. K., Singh, V. K., Srivastava, A. K. (2013). Determinants of Utilization of Antenatal Care Services in Rural Lucknow, India. Journal of Family Medicine and Primary Care, 55–59.Google Scholar
  48. Saigol, R. (2011). Women’s empowerment in Pakistan. Islamabad: Aurat Publication and Information Services Foundation.Google Scholar
  49. Shuib, R., Endut, N., Ali, S. H., Osman, I., Abdullah, S., Oon, S. W., et al. (2013). Domestic violence and Women’s well-being in Malaysia: issues and challenges conducting a national study using the WHO multi-country questionnaire on Women’s health and domestic violence against women. Procedia-Social and Behavioral Sciences, 91, 475–480.CrossRefGoogle Scholar
  50. Silverman, J. G., Gupta, J., Decker, M. R., Kapur, N., & Raj, A. (2007). Intimate partner violence and unwanted pregnancy, miscarriage, induced abortion, and stillbirth among a national sample of Bangladeshi women. British Journal of Obstetrics and Gynecology, 114, 1246–1252.CrossRefGoogle Scholar
  51. Stickley, A., Kislitsyna, O., Timofeeva, I., & Vägerö, D. (2008). Attitudes towards intimate partner violence against women in Moscow, Russia. Journal of Family Violence, 23, 447–456.CrossRefGoogle Scholar
  52. Straus, M. A., Hamby, S. L., Boney-Mccoy, S., & Sugarman, D. B. (1996). The revised Conflict Tactics Scales (CTS2): development and preliminary psychometric data. Journal of Family Issues, 17(3), 283–316.CrossRefGoogle Scholar
  53. UN WOMEN. (2014). Violence against women in politics a study conducted in India, Nepal and Pakistan. New Delhi: United Nations Entity for Gender Equality and the Empowerment of Women.Google Scholar
  54. Unicef. (2009). Child info: Monitoring the Situation of Children and Women. Retrieved March 22, 2014, from violence in the Philippines. Social Science & Medicine, 55, 1385–1399.
  55. Wilson-Williams, L., Stephenson, R., Juvekar, S., & Andes, K. (2008). Domestic violence and contraceptive use in a rural Indian village. Violence Against Women, 14(10), 1181–1198.PubMedCrossRefGoogle Scholar
  56. World Bank. (2011). World bank annual report, 2011. Washington: World Bank.CrossRefGoogle Scholar
  57. World Health Organization. (1994). A user’s guide to the Self Reporting Questionnaire (SRQ). WHO Geneva: Division of mental Health.Google Scholar
  58. World Health Organization. (2001). Putting women first: Ethical and safety recommendations, for research on domestic violence against women. Geneva: WHO, Department of Gender and Women’s Health Family and Community Health.Google Scholar
  59. World Health Organization. (2013). The right to health. Retrieved from
  60. Zakar, R. (2012). Intimate partner violence against women and its implications for women’s in Pakistan. Disserta Verlag: Hamburg.Google Scholar
  61. Zakar, R., Zakar, M. Z., & Krämer, A. (2012). Voices of strength and struggle: women’s coping strategies against spousal violence in Pakistan. Journal of Interpersonal Violence, 27(16), 3268–3298.PubMedCrossRefGoogle Scholar
  62. Zakar, R., Zakar, M. Z., & Krämer, A. (2013). Men’s belief and attitudes towards intimate partner violence against women in Pakistan. Violence Against Women, 19(2), 246–68.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Rubeena Zakar
    • 1
  • Muhammad Z. Zakar
    • 1
  • Safdar Abbas
    • 1
  1. 1.Department of Public Health, Institute of Social and Cultural StudiesUniversity of the PunjabLahorePakistan

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