Assessing the impacts of women's autonomy on their approval of intimate partner violence: a nationwide cross-sectional study.

backgroundIntimate partner violence (IPV) is a severe issue in many low-and middle-income countries and remains a persistent public health problem. Research suggests that controlling attitudes by husbands can increase the risk of women experiencing IPV. To delve deeper into this issue, this study aims to investigate the relationship between women's autonomy and their approval of IPV against women.

methodsThis study utilized the Bangladesh Demographic and Health Survey (BDHS) 2017-18, a cross-sectional nationally representative survey consisting of 20,127 ever-married women aged 15-49. Both unadjusted and adjusted associations between acceptance of IPV against women and four dimensions of autonomy- economic decision-making, self-health-related decision-making, freedom of movement, and non-threatening sexual agreement within partnerships-were investigated. Chi-square tests were used to assess bivariate associations, followed by Cramer's V to measure the strength of these associations. A multivariable binary logistic regression model was then applied to estimate adjusted associations.

resultsOne in every five women approved of IPV. Among the four dimensions of women's autonomy, women having autonomy in self-health care had the lowest prevalence in accepting IPV (6.52%). Except for self-economic decision autonomy, the other three dimensions of women's autonomy showed a significant unadjusted or preliminary association with the perception of approving IPV (p-value < 0.01). Women who shared control over their earnings with their husbands, rather than exercising solo control, demonstrated higher odds of approving IPV (AOR 1.16, p-value 0.04). Additionally, women lacking the final say on important household purchases and visits to close relatives exhibited increased odds of approving IPV compared to those with sole decision-making power (AOR 1.35, p-value < 0.001; AOR 1.37, p-value < 0.001, respectively). Conversely, women who lacked the final say on their own health care were less likely to approve of IPV compared to those with sole decision-making authority (AOR 0.60, p-value < 0.001).

conclusionThis study highlighted that a significant number of women in Bangladesh approve of violence by their husbands, which could be a major obstacle to the reduction of violence in society. Further, the results indicate a significant correlation between women's autonomy-in terms of decision-making, mobility, freedom from threatening sexual relations with their husbands, and access to and control over economic resources- and their approval of IPV. Strengthening women's autonomy emerges as a vital strategy for decreasing the acceptance of IPV, advancing gender equality, and enhancing the overall well-being of women.