Reading, understanding and making sense of research papers is a skill that every single doctor has had to learn during medical school. Reading a scientific paper is a completely different process from reading an article about science in a blog or newspaper. With lots of medical journals, it is essential to develop a method to choose and read the right articles. One can read and appreciate a scientific manuscript if a very systematic approach is followed in a simple and logical manner. The reader should begin by reading the title, abstract and conclusions first. If a decision is made to read the entire article, the key elements of the article can be perused in a systematic manner effectively and efficiently.

“Let us read with method, and propose to ourselves an end to which our studies may point. The use of reading is to aid us in thinking.” Edward Gibbon

Below is a summary of four recent papers in violence against women which every obstetrician and gynaecologist should know.

1. Violence Against Women: A State Level Analysis in India

The principle of gender equality has been enshrined in Constitution of India. Although women can be victim of any of general crimes such as murder and robbery, but there are some gender specific crimes which are being characterized as crime against women, more specifically labelled as violence against women. The fear of violence can prevent women from pursuing education, working or exercising their political rights and voice. Violence against women causes suffering and misery to victims and their families and places a heavy burden on societies worldwide. It is a social construction based on a societal consensus about the roles and rights of men and women. Violence against women is a serious cause of concern as it also deprives women of their freedom and other safety rights which is a very bad indicator for any country’s development. From every region, women have grasped the power of social media to expose their pain and harm, including through use of the hashtags #MeToo, #NiUnaMenos, #BalanceTonPorc, #PrimeiroAssedio, #Babaeko and #WithYou.

Violence against women in India is systematic and occurs in public as well as private spheres. It is underpinned by the patriarchial social-norms and inter- and intra-gender hierarchies. Women are discriminated against and subordinated not only on the basis of sex, but on the other grounds such as caste, class, ability, sexual orientation, tradition and other realities. That exposes them to a continuum of violence throughout the life cycle. The manifestations of violence against women are a reflection of the structural and institutional inequality that is a reality for most women in India. Most forms of violence are not unique incidents but are on-going and can even continue for decades. Because of the sensitivity of the subject, violence is almost universally under-reported.

Young women, early in their careers, are among the least powerful in a workplace and commonly targeted by sexual abusers. Sexual harassment can be bound up with discrimination based on sexual orientation and gender identity. Racial and ethnic myths and expectations can also influence the sexual expectations, prejudices and entitlement that infuse sexual harassment. Thus, violence against women is rooted in discrimination, inequality and share of power, making it challenging to address. Men and women who have not had opportunities to question gender roles, attitudes and beliefs cannot change them. Women who are unaware of their rights cannot claim them. Governments and organizations without access to standards, guidelines and tools cannot adequately address these issues.

The study attempts to calculate the index number of each state for various forms of violence against women that are prevalent in our society and rank the states on the basis of Index Number.


Index for Domestic Violence against Women in India

  • A total of 133154 cases have been reported under domestic violence against women in India.

  • Delhi reported the highest cases of domestic violence against women having index number 190.7 followed by Uttar Pradesh having index number 332.99 followed by Jharkhand showing index number 506.55.

  • Nagaland shows the highest index number (686.86) and, thus, is ranked first among all the States which implies that least cases of domestic violence against women have been reported in Nagaland in 2016.

  • Among the Union Territories, Lakshwadeep (692.29) reported the least cases of domestic violence against women and is ranked first followed by Daman & Diu (686.40) and Andaman & Nicobar(670.68).

  • The most prevalent form of domestic violence in India (as per NCRB Report, 2016) is cruelty by husband/relatives. 1,10,378 cases have been reported under this crime in 2016 in India which accounts for 82.9% of total domestic violence against women in India.


Index for Violence against Women in India

  1. o

    A total of 3,38,059 cases have been reported under violence against women in India in 2016.

  2. o

    Delhi reported the highest cases of violence against women in 2016 showing least index number of 500.20 and is followed by Uttar Pradesh (994.70) which is followed by Telangana (1050.50) followed by Orissa (1076.38).

  3. o

    Among the States, Nagaland stands first showing the highest index number (1561.94) implying that Violence against Women is least prevalent in Nagaland which is further followed by Manipur (1539.88). Mizoram stands third (1502.21) and is followed by Meghalaya (1473.34) and then Gujrat (1461.81).

  4. o

    Among the UT’s, Dadara & Nagar Haveli (1461.86) reported the least cases of Violence against Women and is ranked first followed by Lakshwadeep (1411.17) and Andaman & Nicobar (1390.10).

  5. o

    Cruelty by Husband/Relatives is the most prevalent form of violence against women in India (as per NCRB report). 1,10,378 cases have been reported under this crime which accounts for 32% of total cases of violence against women in India. 84,746 cases have been reported under Assault on Women with intent to outrage her modesty which accounts for 25% of the total reported cases of violence against women in India and is the second most prevalent crime. 64,519 cases of incidence of Kidnapping & Abdication have been reported in 2016 which accounts for 19% of the total incidence cases reported under violence against women in India and is the third major crime against women.

2. Experience of gender-based violence and its effect on depressive symptoms among Indian adolescent girls: Evidence from UDAYA survey

This study focuses on married and unmarried girls aged 15 to 19 years, belonging to Uttar Pradesh and Bihar, India. This study attempts to examine depression level among married and unmarried girls who have faced violence against them. With the unprecedented growth in social networking, online digital platform and its accessibility, the study also brings out the pertinent aspect of internet based violence and its psychological outcome on adolescent girls. Hence, the study can be seen as an important and needed value addition to the existing pool of knowledge on the subject.

The study uses Understanding the lives of adolescents and young adults (UDAYA) project data for Uttar Pradesh and Bihar. Depressive symptoms among adolescent girl are the outcome variable of the study. Descriptive statistic and bivariate analysis has been used to get to preliminary results. Chi-squared test is used to test the significant of variables. Further, multi-variate analysis (logistic regression) was used.

Almost 29, 23 and 26 per cent of married adolescent girls had faced emotional, physical and sexual violence, respectively. It was found that about five per cent of unmarried and eight per cent of married girls had high depressive symptoms. It was found that unmarried adolescent girls who had witnessed their father beating mother were 71 per cent more likely to suffer from higher depressive symptoms. Adolescents who faced perpetrated bullying had 90 per cent and 86 per cent higher likelihood to suffer from higher depressive symptoms

The study goes beyond intimate partner violence and includes various covariates to explain the association between violence and depressive symptoms among married and unmarried adolescents. Hence, more inclusive policies are needed to address the issue of violence against women as the spectrum of the violence is expanding with time.

3. Prevalence of domestic violence against women in informal settlements in Mumbai, India: a cross-sectional survey

Domestic violence against women harms individuals, families, communities and society. Perpetrated by intimate partners or other family members, its overlapping forms include physical, sexual and emotional violence, control and neglect. We aimed to describe the prevalence of these forms of violence and their perpetrators in informal settlements in Mumbai.

Design - Cross-sectional survey.

Setting - Two large urban informal settlement areas.

Participants- 5122 women aged 18–49 years.

Primary and secondary outcome measures - Prevalence and perpetrators in the last year of physical, sexual and emotional domestic violence, coercive control and neglect. For each of these forms of violence, responses to questions about individual acts and composite estimates.

Results - In the last year, 644 (13%) women had experienced physical domestic violence, 188 (4%) sexual violence and 963 (19%) emotional violence. Of ever-married women, 13% had experienced physical or sexual intimate partner violence in the last year. Most physical (87%) and sexual violence (99%) was done by partners, but emotional violence equally involved marital family members. All three forms of violence were more common if women were younger, in the lowest socioeconomic asset quintile or reported disability. 1816 women (35%) had experienced at least one instance of coercive control and 33% said that they were afraid of people in their home. 10% reported domestic neglect of their food, sleep, health or children’s health.

Conclusions-Domestic violence against women remains common in urban informal settlements. Physical and sexual violence were perpetrated mainly by intimate partners, but emotional violence was attributed equally to partners and marital family. More than one-third of women described controlling behaviours perpetrated by both intimate partners and marital family members. We emphasise the need to include the spectrum of perpetrators and forms of domestic violence—particularly emotional violence and coercive control—in data gathering.

4. Understanding Domestic Violence in India During COVID-19: a Routine Activity Approach

There is a preliminary evidence to conclude that domestic violence during the COVID-19 increased globally. The restrictions imposed to curb the spread of virus resulted in an increase in violence. On 22nd March 2020, the Prime Minister of India announced a nationwide lockdown for one day. This lockdown was subsequently extended for a week, then for 21 days and finally until 3rd May 2020 to contain the spread of COVID-19. India declared COVID-19 a “notified disaster” under the Disaster Management Act, 2005. Extended lockdown and other social distancing measures imposed to curb the pandemic made women more vulnerable to domestic violence. Women were fighting a shadow pandemic inside their homes.

In total, 59 articles were reviewed that published news related to domestic violence during COVID-19 in India.

Through the content analysis, four relevant incidents were found related to the absence of a capable guardian in the house. The absence of a capable guardian facilitated domestic violence during the lockdown. The prime formal source that acts as a capable guardian against any form of violent crime is the police. Content analysis revealed that there was a shortage of police force during the lockdown. When the pandemic hit the nation, much of the police force was at the frontline, engaged in the strict implementation of lockdown. In addition, courts were not functioning regularly and were only hearing emergency pleas. The next formal source that acts as a capable guardian for the victims of domestic violence is the support services. These support services are NGOs, ASHA workers, and counselling services providers. Due to lockdown and travel restrictions, victims’ parents or family members were not able to intervene physically.

Cohen and Felson repeatedly highlighted that changes in our routine activities provide an opportunity to commit more crimes. With the pandemic affecting almost all the countries in the world, there has been a significant change in our routine activities. With India and other countries imposing lockdown or issuing stay-at-home orders, the usual routine activities of people have completely changed. During the lockdown, people did not go out of their homes for work, school, or leisure activities. They were only allowed to step out of their homes to access essential services. People engaged in providing essential services were the only ones who continued with their routine activities even during the lockdown. As Cohen and Felson (1979) highlighted it is the legal routine activities of individuals that provide opportunities for illegal activities (Cohen and Felson 1979). Applying this principle to the issue in hand, the legitimate activity of following a legal order to stay inside the home to contain the spread of COVID-19 resulted in allowing a likely offender who saw their partners as suitable targets to inflict violence, in the absence of capable guardians.

Routine Activity Theory is applied in a few studies to understand domestic violence. Removal of one of the three factors that facilitate domestic violence from existing in the same time and space, i.e., a motivated offender, suitable target, and absence of a capable guardian could result in a drastic decrease of victims of domestic violence.