Abstract

The term violence against women means any act of gender-based violence that results in psychological, physical, sexual harm, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring both private and public life. Researchers used a quantitative study approach with simple random sampling techniques. Researchers selected sample group 384 women and girls were aged 15-49 years. However, data was collected from 356 women while 28 were refused. The researchers analyzed the data with inferential statistics regression test to draw linear relationship between dependent and independent variables. The results shows that main causes of VAW are; women position, demand of education/employment, lower family caste, demand of health, gender stereotype and political participation. The health consequences are; women attempting suicide, unintended pregnancies, miscarriage, low birth/still birth and women died due to violence. The study concluded that VAW is a serious social issue in the study area and it’s badly affect women. It is recommended that to include lesson related to VAW and bring awareness regarding women rights

Key Words

Women, Violence, Causes of VAW, Consequences, Malakand, Khyber Pakhtunkhwa, Pakistan

Introduction

Violence against women is primary human rights violation. In many societies women are facing violence due to her inferior status in domestic sphere and dependency on her men family members. VAW are occurred in many forms including physical, psychological, emotional and sexual violence. Behavioural and public health researchers argue that VAW affect her physically, mentally, socially, economically and emotionally around the world. 

According to World Health Organization (WHO) 2012 estimates, 1/3 women are expected to experience any kind of violence. Public health and behavioral studies found that women in developing countries experienced physical, psychological, emotional and sexual violence. It is revealed in many research studies that physical violence is experienced on daily basis by women in age category of 15-49 years. In Pakistan, according to Pakistan Demographic and Health Survey (2017-18), 28 percent of women aged 15-49 years experienced physical violence. In the same report physical violence is categorized as beating, pushing, kicking, pulling hairs, punching, choking, burning and dragging (National Institute of Population Studies [NIPS], 2019). The physical VAW is also statistically shown in India with 70 percent women experienced it (Kumar, 2019). According to PDHS-2018, 26 percent women experienced psychological and emotional violence. It is explained that psychological violence are categorized as humiliating, threaten and feeling bad.

In Bangladesh 54, percent women faced psychological violence while another study conducted in Turkey shows, 72.6 percent women experienced psychological violence in daily life (Alakan, 2022 & Khatun, 2020). It is statistically shown in many research studies that sexual violence against women and girls are reported on daily basis in Pakistan (Khyber Pakhtunkhwa Commission on the Status of Women [KPCSW], 2020; National Institute of Population Studies [NIPS], 2019; Ali, 2008).  Various research studies highlighted that the main agents of VAW are men including family men members, women and men outside in public sphere (Suri, 2022; Ellsberg, 2021; Somach, 2009 & Macmillan, 2002). It is statistically shown that in Pakistan 80 percent women experienced physical violence from husband while 17 percent women faced from mother-in-law and sister-in-law in Pakistan (National Institute of Population Studies [NIPS], 2019). 

It is revealed that women have various physical, psychological and emotional consequences due to violence. 

The present study mainly focused to investigate the socio-economic causes of violence against women and to examine various consequences of violence against women.

Research study revealed that there are various driving factors of VAW around the world. It is stated that gender itself encourage VAW. According to the WHO (2009), due to gender roles and practices that give one gender more power than the other which creates inequalities. As a result, many societies view women as inferior to and dependent upon men's judgment. (WHO, 2009). According to another study it is discussed that both low developed and emerging nations have high rates of illiteracy. Due to cultural and religious restrictions, Pakistan has a low percentage of women literacy which is the main factors contributing to poor women's status and the prevalence of VAW in both the public and private spheres (Bhattacharya, 2014).

In Pakistan the male dominating society especially in rural and sub-urban regions. Compared to male, women are primarily at the bottom of the educational system. It has believed that women are confined to the home and denied education (Noureen, 2011). It is revealed in another study that men are socially superior to women not only in the four-wall but also in the public realm. The dominance of men in all spheres of life has degraded the position of women, including their exclusion from the political process, restricted access to education, rigid pardah system, mate selecting process, contact with family members, and lack of social networking. Even if they have a basic education, women and girls still experience abuse (Banozic, 2018).

Economic drivers stood out as one of the key factors causing violent behaviour in the society. The women deprivation from jobs creates frustration within family and society as well. This is because women are considering weaken segment of society (Qaisrani, 2016). It is also shown in another study that economic abuse is a particularly severe and fatal type of violence. Economic abuse is directly link with poverty. Despite advancements in women's economic activity, many women continue to experience various forms of economic abuse, such as restricted access to money and credit, lack of control over access to agricultural resources, health care, employment, and education, exclusion from financial decision-making, unequal pay for work of the same value as that of men, and discriminatory traditional laws on inheritance, property rights, and use of communal land (Fawole, 2008).

Caste imposes massive obstacles to their full attainment of civil, political, economic, social, and cultural rights. Caste-based violence against women is one of the vital issues of equality and social justice (Kamble, 2020). It is discussed in another study that the core causes of violence against women from lowly castes are very deep and cannot be eradicated without extensive efforts. (UN Human Rights Council [UNHRC], 2014).

According to Qaisrani, the lack of financial means to women are the core cause of VAWG. Due to the economic instability, women are denied from fundamental requirements. If women demand access to healthcare facilities they are vulnerable to abuse, and a lack of financial means may prevent girls and women from receiving an education (Qaisrani, 2016). According to a study conducted by Habib in Pakistan (2021), women in Pakistan, particularly those living in rural regions, face several barriers to accessing healthcare facilities because women depend on males while the men are the family's head. Low family income is another factor that affects both married and unmarried women health (Habib, 2016). 

Another study revealed that gender stereotypes is a barrier to women's rights. Discrimination against women includes both the inequalities that they experience on a daily basis in the private and public spheres as well as behaviors that are directed at them (Office of the High Commissioner for Human Right [UHCHR], 2014). According to another study that women are less powerful when gender stereotypes are more prevalent, which means they have less trustworthy outside options to halt the assault (Barili, 2021).

It is discussed in another study that patriarchy is the foundation of Pakistani society. Where women are not allowed to participate in politics and have limited decision-making power, they are subject to the male family members. Women have very little influence in politics (Mlambo, 2019). It is found in another study that political parties’ patriarchal structures continue to disapprove of women entering to politics (Ahmad, 2017). 

Due to the VAW different consequences are experienced by women which are mainly categorized in health and psychological consequences.

Pakistani society is normatively patriarchal. The abuse may be physical, loss of a woman's children or herself dead or disabled. Women's health and the welfare of their families are negatively impacted by violence against them in well-known and well-documented ways. It is obvious that in Pakistan, abuse of women and concerns with women's mental health. Anxiety, sadness, and suicidal thoughts are all significantly predicted by experiences of domestic abuse (Karmaliani, 2012).

Women were mostly victims of physical, psychological, and sexual abuse from intimate partners as well as from family members. Women experience significant levels of despair, stressful situations, and suicidal thoughts (WHO, 2005). Women's health, particularly their sexual and reproductive health, are harmed by violence against them, which also violates their rights and fundamental freedoms (Rizvi, 2019).

Unwanted pregnancies, physical injuries, and suicide attempts are only a few of the harmful effects of violence on women's health. Violence is also linked to problems with women's mental health, such as despair, anger, eating disorders, and suicidal thoughts (Lysova, 2016). The effects of VAW on both physical and mental health are extensive. VAW has the potential to cause miscarriage or the spread of sexually transmitted illnesses like HIV/AIDS (Blanchfield, 2011).

Methods

Research is a methodical approach to learning new information and finding solutions to problems. Quantitative research and qualitative research are the two main methods used to undertake social research (Goundar, 2012).

The authors developed this research study from Mphil dissertation of first author. The first author conducted Mphil research on “Violence Against Women: A Cross Sectional Study Conducted in Malakand, Pakistan” in the Department of Sociology, Abdul Wali Khan University Mardan. 

In quantitative approach research mainly focused to draw association and relationship between dependent and independent variables (Abuhamda, 2021). Quantitative research method with cross sectional research design was used in the study to draw association of variables. 

Study population is the whole population in a research study. The units of a group, community, or specific civilization are the study population. Individuals are the primary demographic units in the social sciences (Shukla, 2020). All adolescent girls and women aged 15-49 years were the study population. 

Sample population in quantitative research approach represent the whole population (Bhatt, 2020). The sample population in the study was selected through application of Um-e-Sekran and 384 respondents were randomly selected.

Cluster sampling technique is used to divide unit of analysis in different cluster and later sample are selected with different quantitative technique (Showkat, 2017).  The study district was divided into two tehsils and 28 union councils through cluster sampling technique while 384 respondents were selected randomly in household survey. 

In quantitative research responses are collected through use of different tools including questionnaires, interview schedules, structured interviews, mapping form and surveys (Ali, 2021). In the study self-administered questionnaire was used to collect data from educated respondents, while the same tool was used as interview schedule with uneducated respondents. 

The act of gathering data is one of the most important parts of doing research, without it the researcher or researchers cannot carry out their work. A necessary instrument is needed by the researcher in order to gather data from the target or chosen sample (Kabir, 2016). Researchers applied several kinds of methods and approaches in the current study to collect data. Women are not permitted to engage with men or other unknown parties in the research region due to cultural sensitivity and patriarchy. In order to conduct and gather responses from women respondents, researchers hired the services of four female research assistants. The collection of data took place every day from sunrise to dusk. Researchers visited several schools and colleges to request an appointment with the principle or head of the institution for a proper meeting on the study project and to go through the research's objectives with the appropriate authorities. Due to cultural sensitivity or other risks/threats, only a small number of school and college principals permitted data collection from the female staff members. Following the principals' approval, female research assistants went and engaged with female school staff members to gather data. In order to get data from the women, researchers and female research assistants visited to the targeted union councils. Before gathering the data, the researchers met with the male members of the respondent's family to explain the purpose of the study. If the male members were convinced, they gave permission. Women research assistants encountered a number of challenges in collecting data in the study area. Due to cultural sensitivity and fear of additional abuse from male family members, women did not want to disclose their replies. Some respondents, expressed doubt that researchers had been hired by organizations and claimed that they were unaware of the primary goal of the study and the objectives for which you would utilize their data. The principal researcher and his team gathered data from the female research assistants on a daily basis (8 am–5 pm) to check out each questionnaire and then pin out the partially filled questionnaires over the course of three months (September–November, 2022). In this study, 28 women refused to participate in. 

Researcher utilize data analysis to evaluate data and divide up enormous amounts of data into smaller portions (Lutabingwa, 2007). Quantitative data in the study was analyzed through SPSS. Descriptive statistics was used to draw simple frequencies and percentages of responses while in inferential statistics, binary logistic regression was used to draw relationship between cultural factors and VAW. In binary regression the relationship between VAW and consequences were analyzed. 

An additional aspect of research ethics is the interaction with human participants. Prior to collecting data from human participants, it is crucial to secure ethics permission for human research and to maintain the privacy of the respondents names and addresses (Fleming, 2018). Any research that involves people or other living things such as; plants, animals or humans must take ethical consideration into consideration. Due to the conservative society, the first author initially discusses the study nature and goals with the males in the women's families. The data was gathered by a female research assistants after the male family member(s) gave their consent. Women are not permitted to sign any paperwork in the research location, thus verbal agreement from the respondents is taken into account while gathering data. Research assistants utilized a separate location within their homes, schools, and colleges throughout the household survey to freely reply to the questions. To minimize risk to research participants, the respondent's identity, phone number, and home address are kept private. Since the researcher and his team are not permitted to capture audio or video, just the questionnaire is filled out. The researcher maintained exclusive custody of all the information gathered as well as the questionnaire/interview schedule. The filled questionnaire/interview schedule and related field notes are available to read but prior approval of the first author is required. 

Result and Discussion

Table 1

Association of socio-cultural drivers and any kind of violence experienced by women (N=356)

Socio-cultural drivers	Experienced any kind of violence		OR, 95 CI, EXP(B)	P-value
	No F (%)	Yes F (%)
Women Position cause violence
No	6 (4.1)	141 (95.9)	1.000
Yes	14 (6.7)	195 (93.3)	.273 (.090-.826)	*
Demand/Access to Education cause violence
No	14 (7.8%)	166 (92.2%)	1.000
Yes	6 (3.4%)	170 (96.6%)	2.040 (.685-6.077)	__
Demand of Employment cause violence
No	16 (7.6%)	194 (92.4%)	1.000
Yes	4 (2.7%)	142 (97.3%)	3.116 (.896-10.841)	__
Lower Family Caste cause violence
No	16 (6.3%)	237 (93.7%)	1.000
Yes	4(3.9%)	99 (96.1%)	1.602 (.466-5.501)	__
Access/Demand of Health Facilities cause violence
No	13 (6.8%)	178 (93.2%)	1.000
Yes	7 (4.2%)	158 (95.8%)	1.632 (.577-4.618)	__
Gender Stereotype cause violence
No	19 (7.3%)	240 (92.7%)	1.000
Yes	1 (1.0%)	99 (99.0%)	7.959 (1.002-63.217)	*
Restricted from Political Participation
No	16 (10.7%)	134 (89.3%)	1.000
Yes	4 (1.9%)	202 (98.1%)	6.906 (2.118-22.525)	**

P-Value: *=.05             **=.01

 




Table 01 shows the association between women social position and experienced any kind of violence in the family. The relationship is found significant with P-value .022 where 93 percent women experienced violence due to low social position. A study conducted by Ashraf (2017), in Pakistan women are treated subordinate and their mobility is restricted. Women are experienced violence when they demand to take part in family affairs decision making. In other studies it is discussed that in patriarchal societies women are treated low in social position (Dahal, 2022 & Pokhriyal, 2022).

Table 01 shows the association between women gender stereotype and experienced any kind of violence. The relationship is found significant with P-value .050 where 99 percent women experienced any kind of violence due to their gender. Gender stereotyping is counted the key hindrance to women rights (Tabassum, 2021), while it is discussed in another study that women are being treated with different lens in social sphere where women are oppressed in their family, workplace and public sphere (Leon, 2023).

Table 01 also shows the association between women restricted from political participation and experienced any kind of violence. The relationship is found significant with P-value .001 where 98 percent women experienced any kind of violence due to demand of political participation. It is revealed that women are controlled from political participation due to male authority, their cultural and rigid traditions (Alam, 2021 & Ahmad, 2019). It is discussed in another study that In the name of traditional gender norms, relatives and party colleagues may sabotage women’s political participation (Krook, 2017).

Other variables association with violence against women including access to education, demand of employment, lower family caste and access to health facilities are found with no relationship.




 

Table 2

Association of health/psychological consequences and experienced any kind of violence against women (N=356)

Psychological/Health consequences	Experienced any kind of violence		OR, 95 CI, EXP(B)	P-value
	No F (%)	Yes F (%)
Women Attempting Suicide Due to Violence
No	13 (14.3)	78 (85.7)	1.000
Yes	7 (2.6)	258 (97.4)	6.447 (1.603-25.927)	*
Women Experience Unintended Pregnancy Due to Violence
No	10 (23.8)	32 (76.2)	1.000
Yes	10 (3.2)	304 (96.8)	19.827 (3.103-126.699)	*
Women Experience Miscarriage Due to the Violence
No	5 (14.3)	30 (85.7)	1.000
Yes	15 (4.7)	306 (95.3)	0.63 (.008-.476)	*
Women Experience Low Birth/Still Birth Due to Violence
No	8 (19.0)	34 (81.0)	1.000
Yes	12 (3.8)	302 (96.2)	3.475 (.499-24.192)	__
Women Died Due to the Violence
No	10 (10.8)	83 (89.2)	1.000
Yes	10 (3.8)	253 (96.2)	.262 (.053-1.291)	__

P-Value: *=.05 **=.01

 




Table 02 shows that the association between women attempting suicide and experienced any kind of violence. The relationship is found significant with P-value .009 where 97 percent women experienced violence and attempting suicide. It is discussed in a study that attempting suicide or suicide  are happening in several regions around the world and reason for the attempting suicide is due to family, personal level and community (Bergen, 2021). The socio-economic and socio-cultural drivers against women are lead to attempt suicide (Ostadtaghizadeh, 2023 & Shidhaye, 2023). Higher rates of suicide attempts were shown to be significantly associated with physical abuse, sexual abuse, emotional abuse, emotional neglect, physical neglect, and combination abuse (Kisaakye, 2023).

Table 02 shows that the association between women experience unintended pregnancy and experienced any kind of violence. The relation is found significant with P-value .002 where 97 percent women experienced violence and experience unintended pregnancy. It is revealed in a study that unintended pregnancy is consider social issue and health issue worldwide. Women are facing unintended pregnancy/pregnancies due to male dominancy and women subordinate position in family and society as well. Unintended pregnancy affect negatively on women health and as well as psychologically depressed (Ajayi, 2020). Unintended pregnancies are related with no/low education, younger reported age at sexual debut, being married earlier (Namukisa, 2023). The individual, social, economic, cultural and policy factors are associated with unintended pregnancy (Wang, 2023).

Table 02 shows that the association between women experience miscarriage and experienced any kind of violence. The relation is found significant with P-value .007 where 95 percent women experienced violence and experience miscarriage. It is conducted in a study that Violence against women has a harmful impact on both the health of the victim and the unborn child. Unwanted pregnancy may result in miscarriage or abortion, often physical, sexual, and psychological trauma to women results in miscarriage. Despite this, there are harmful effects on the unborn child before, during, and after pregnancy (Bent-Goodley, 2007). According to Ahinkorah (2021), partner violence, controlling behaviors, depression, psychological distress and suicidal though are associated with miscarriage (Ahinkorah, 2021).

Other variables association with violence against women including women face low birth/still birth due to violence and women died due to violence are found with no relationship.  

Conclusion and Recommendations

There are several contributing elements to violence against women in Pakistan, such as the patriarchal social structure, male dominancy, and the repression of women's civil and social rights. Girls and women were not given equal access to healthcare, work opportunities, or educational opportunities. Violence against women is caused by a number of socio-cultural factors, including women's status, lower familial castes, and gender stereotypes.

In the country as a whole, there are several health and psychological effects of violence against women, including thoughts of suicide, unwanted pregnancies, miscarriages, and low birth or still birth rates.

It is concluded that despite the government's numerous policy-level actions, violence against women continues to exist in the country. The majority of society, in-laws, and family males are the leading perpetrators of violence against women.

The study recommended to include lesson related to VAW causes and consequences. It is recommended to bring awareness any general masses regarding women rights in Pakistani society. It is also recommended that psycho-socio counselling may be started for VAW seminars and the society.

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