03184nas a2200325 4500000000100000008004100001653001500042653001000057653002800067653002000095653002100115653001100136653001100147653001600158653002600174653001000200653001500210653001700225653001700242653001600259100001100275700001200286700001300298245010200311856008900413300000800502490000700510520232700517022001402844 2015 d10aAdolescent10aAdult10aCross-Sectional Studies10aData Collection10aDisabled Persons10aFemale10aHumans10aMiddle Aged10aMultivariate Analysis10aNepal10aPrevalence10aRisk Factors10aSpouse Abuse10aYoung Adult1 aPuri M1 aMisra G1 aHawkes S00aHidden voices: prevalence and risk factors for violence against women with disabilities in Nepal. uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377054/pdf/12889_2015_Article_1610.pdf a2610 v153 a

BACKGROUND: There is an increasing body of evidence on the extent and predictors of violence against women in Nepal. However, much of the published research does not yet take into account additional features of marginalization and vulnerability suffered by some women - for example, women socially excluded on account of their disability. Critical gaps exist in empirical data on the extent, risk factors, access to care, socio-economic and health consequences of violence among women with disabilities in Nepal. This paper addresses some these gaps and aims to promote evidence-informed policy and programme responses in Nepal.

METHODS: We conducted a cross-sectional survey of 475 women with disability aged 16 years and above in three districts in Nepal. In-depth interviews with 12 women who reported violence in the survey were also carried out. Using multivariate statistical methods we estimated the prevalence and risk factors for violence experienced both over the past 12 months and lifetime.

RESULTS: Over the lifetime, 57.7% of women reported they had ever experienced violence, including emotional violence (55.2%); physical violence (34%); and sexual violence (21.5%). Over the preceding 12 months, 42% of women reported that they had experienced violence. Multivariate analysis showed that women with disabilities who were young, working in paid employment, and those who required permission from husbands/family to go to health centres or participate in community organizations were at increased risk of violence. Women experienced a range of negative outcomes from violence - including physical and emotional trauma. However, a majority of women did not seek care or redress from the health, justice or other sectors.

CONCLUSIONS: Women in Nepal are at high risk of violence, often from members of their immediate family or local community. Rates of violence are higher in women with disability than among women in the general population. Tackling violence requires a comprehensive approach that addresses the root causes of women's unequal position in society, and builds upon principles of equity and justice to ensure that all women are able to realize their rights to a life free from violence.

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