World Health Organization Gender and Women’s Health Challenges of a short module in surveys on other topics vs a specialized survey Henrica A.F.M. Jansen

World Health Organization Gender and Women’s Health

Challenges of a short module in surveys on other topics vs a

specialized survey

Henrica A.F.M. Jansen

UNECE Work Session on Gender Statistics, Geneva, 18-20 October 2004


What this talk is about

• Comparison of the two ways of measuring violence

• Examples highlighting some (remaining) challenges for measuring violence

• Conditions that need to be in place when using a short module

• Importance of interviewer training


Two trends in international violence research

• Addition of violence questions to studies designed for other purposes

• Focused specialized studies (national and regional)


Strengths and weaknesses of the two approaches

Short module in survey:

• Official statistics

• Includes other variables

• Less detailed information on violence

• Less attention to safety

• Lower prevalence

Specialized survey:

• Often smaller scale• More attention to safety

issues• Measures to enhance

disclosure• More in-depth information

on violence• Higher prevalence estimates


What is your objective?

• To raise awareness about the problem• To influence policy

• To monitor trends• To contribute to indicators at global level• To compare between countries• To understand more about violence, the

associations, risk and protective factors

Short module

Special survey


Challenges to developing a common set of indicators on violence against women1. Enhancing comparability

– How violence is defined – How is violence measured

2. Enhancing disclosure– Opportunities to disclose, context,

skill of interviewers

3. Enhancing safety– privacy, special training for

field staff, support for respondents and interviewers

Discussed already


Factors that affect disclosure

• How the questions are phrased

• Number of opportunities to disclose

• Context in which questions are asked

• Characteristics and skill of interviewers

• Social stigma attached to issue


Single versus multiple questions to measure abuse, Nicaragua

Since you were 15, has anyone ever hit or physically mistreated you? Who?

• 14% of women reported abuse by partner

Using a more detailed instrument that asked about occurrence and frequency of acts...

• 29% of women reported physical abuse by a partner


“…In the first question, they would say that he didn’t beat them, but when we got to the other questions, then they would say yes, sometime he beats me and kicks me or uses a gun, or whatever.”

(interviewer, Nicaraguan DHS)


Measurement of Child Sexual AbuseWHO Study

• Before the age of 15, do you remember if any one in your family ever touched you sexually or made you do something sexual that you didn’t want to?– If yes, who did this to you?

– How old were you when it happened for the first time?

– How old was this person?

– How many times did this happen? Once/twice; few, many?

• Probes: school, friend or family, neighbor; stranger or anyone else?


Anonymous reporting of sexual abuse before age 15


Comparison of methods of measuring sexual abuse before age 15

20

8

19 18

0

10

20

30

Peru Urban Peru Rural

Interview Anonymous


Percentage reporting sexual abuse before age 15, Tanzania

4

1112

0

10

20

Tanzania Urban

Interview Anonymous Both combined


More ways to enhance disclosure (context)

• Establishing trust and credibility in community

• Letters from proper authorities to households

• One woman per household - Visible process of randomization

• Sensitivity and engagement of interviewers

• Privacy – creative strategies needed

• Uniform, IDs.


Importance of interviewer selection and training

• Thus far, we saw the mode, question wording, order, context, privacy etc has effect on disclosure

• But….

• Even if all this is the same, the type and skills of interviewer still makes a difference.


Evidence of the value of training Serbia and Montenegro 2003

• 13 inexperienced, carefully selected interviewers, trainedduring 3 weeks

• 21 professional interviewers, selected because of their interest in the topic, trained during one day


Special training vs professional interviewersInexperienced,

3 week training

Professional,

1 day training

Response rate 93% 86%

Disclosure rate 26% 21%

Respondent satisfaction – with violence

46% 29%

Respondent satisfaction – without violence

46%

38%


• "Somehow it made me feel good, because it was something that I had never told anyone before. Now I’ve told someone".

• --Respondent, Brazil


Examples of short modules

• DHS violence module

• CDC violence module in reproductive health surveys

• IVAWS subset of questions

• WHO violence against women instrument– (partner violence and non-partner violence)


Minimum conditions for using a short module

• Measures to protect safety of respondents and

interviewers

• Crisis intervention and referrals to specialized

services for respondents who need this

• Special training and emotional support and

follow-up for interviewers


Minimizing risk to the respondents:

• Total privacy and confidentiality

• One woman interviewed per household

• Study is not presented to household as

asking questions on violence


These minimal set of conditions are crucial for

• Doing research safely for all involved

• Enhancing disclosure

• Data quality – scientific rigour

• Political importance, to be able to do fieldwork in future research


Thank you!

[email protected]

http://www.who.int/gender/

Documents

World Health Organization Gender and Women’s Health Challenges of a short module in surveys on other topics vs a specialized survey Henrica A.F.M. Jansen