Who's at risk? Factors associated with intimate partner violence in the Philippines

Abstract

We describe the individual and household characteristics associated with intimate partner violence (IPV) in the Philippines, using data from the Cebu Longitudinal Health and Nutrition Survey (CLHNS). We also examine 56 in-depth interview transcripts to explore the context of IPV. We focus our analysis on patterns of household decision-making as a measure of the interpersonal dynamics between husbands and wives. Thirteen percent of women in our sample reported IPV. While economic factors are often implicated in the cycle of violence in households, we find employment status and relative earnings do not predict IPV. Lower levels of household wealth and urban residence are associated with a higher likelihood of IPV. Patterns of household decision-making emerge as strong predictors of violence. The greater the number of decision-making domains men dominate, the more likely they are to use IPV; however, we also find that when women dominate household decisions, they are also more likely to experience IPV. Only 6% of women reported IPV when all household decisions were made jointly compared to 25% when no decisions were made jointly.

Introduction

Violence against women is a serious public health concern and recognized as a global health problem. Violence against women is as serious a cause of death and incapacity as cancer and a greater cause of illness than traffic accidents and malaria combined (World Bank, 1993). It is estimated that at least 20% of the world's women have been physically or sexually assaulted by a man (World Bank, 1993) and that between 16% and 52% of women have been physically assaulted by an intimate partner (WHO, 1997). Despite the prevalence of intimate partner violence (IPV), few studies have examined what happens in the household to spark spousal violence, although the relationship between selected measures of women's autonomy and IPV is starting to be explored (Koenig, Hossain, Ahmed, & Hagga, 1999; Jejeebhoy & Cook, 1997). How couples negotiate decisions, both large and small, may be an important risk factor for IPV.¹ We use the term IPV throughout this study. There is a substantial body of literature that describes the variation in definition and measurement issues (for a good summary see Desai & Saltzman, 2001). While IPV can include emotional, psychological, and sexual violence, the current study focuses only on physical violence.

Patterns of household decision-making characterize the interpersonal dynamics between husbands and wives. Interdisciplinary research has focused on the reasons why one spouse may dominate decision-making (Blood & Wolfe, 1965; Blumberg, 1991) and how within families, when one individual decides for others, they may not consider the well-being of all family members (Sen, 1990; Thomas, 1990; Dwyer & Bruce, 1988). Few studies have looked at the impact of spousal domination of decision-making on the well-being of women. Researchers are beginning to explore impact of patterns of decision-making on the well-being of women (Hindin, 2000a), reproductive health and decision-making (e.g. Hindin, 2000b; Basu, 1996; Gwako, 1997), and some measures of women's status are being explored in connection with IPV (Koenig, Hossain, Ahmed, & Hagga, 1990; Jejeebhoy & Cook, 1997; Heise, Ellsberg, & Gottenmoeller, 1999). In addition, a recent review of the literature on IPV suggests that understanding the “origins and dynamics of different kinds of control in relationships will lead to progress in understanding domestic violence...” (Johnson & Ferraro, 2000, p. 955). In this study, we explore the social factors related to IPV, including domination of household decisions. We aim to determine whether gender relations in marriage are related to IPV in the Philippines.

It is theoretically plausible that women's economic empowerment through the process of development may be linked to IPV. On the one hand, women who earn an income and help themselves and their families have means to get out of a bad marriage or not to marry at all. When women have more options, this should decrease the likelihood of their being in an abusive relationship. Kabeer (1999, p. 149) suggests that poor women are often most vulnerable to violence because “they are most exposed to the risk of violence and least able to remove themselves from violent situations”. On the other hand, women's economic empowerment may promote male insecurity and feelings of economic inadequacy, leading to more violence in relationships.

In support of the idea that economic empowerment can decrease IPV, Blumberg (1991) provides evidence that having their own income improves women's ability to have say over fertility preferences, input into household decision-making, and self-esteem. Accordingly, when women feel empowered, they are better able to take action at the household level to improve their own and their children's well-being (Blumberg, 1991). Further, outside the household, they may bring issues of concern to women, such as domestic violence, to the fore–through mobilization of women's groups, political organization, and media coverage. (e.g. Rakowski, 1991). In India, Rao (1997) finds that even after controlling for total household income, that the greater the wife's income, the lower the likelihood that she will be beaten.

In contrast to the inverse association between women's economic empowerment and domestic violence, Blumberg (1991) also points to evidence that as women gain more domestic power due to earned income, they may also face resistance and violence from their spouses (see Roldan, 1988 for evidence of violence in households where husbands are unemployed and women are employed).

Oropesa's study of Mexican households shows that in households where women are sole or dual-earners, there is no more or less violence than in households where husbands are the breadwinners, providing evidence that there is no relationship between women's economic empowerment and abuse. He does find that when both spouses are unemployed there is a greater risk of violence. However, Oropesa (1997) does not look separately at models where the women are the sole earners, where there may, in fact be more IPV.

A report issued by the National Research Council (1996) suggests that a wide range of factors are implicated in the cycle of violence against women. However, these factors cannot be considered in isolation. The report suggests that multiple causes need to be considered at once and these causes can range from the individual to the macro-level. Dobash & Dobash (1998) suggest that the theoretical advances in the quest for an explanation of violence against women have often been narrowed by “disciplinary lines”. They highlight the importance of mixed methods of gathering data as well as the importance of taking a context-specific approach.

In our study, we incorporate both qualitative and quantitative methodologies to provide a couple-level context of violence. We consider the status of women at the national or society level as well as their status within the household. We explore household decision-making within couples as an indicator of power relations between men and women. We feel that deviations from the normative marital dynamic, as described below, may result in more reports of IPV.

On the surface, the public image is that women have high status relative to men. According to Licuanan (1993, p. 259), “observing the highly visible women in Philippine society, including a woman president, women in Congress, in the Supreme Court, and in the Cabinet as well as in business and the private sector, most Filipino men (and women) sincerely believe that Filipino women enjoy equal status to men”. In addition to their public presence, legally, women are seen as equals to men. Women's educational attainment is quite similar to men's, unlike the situation in many developing nations. Despite this visible evidence of equality, gender relations within households and families may vary. Based on the results of a five-country study, Mason (1996) concludes that women in the Philippines have more autonomy than most Asian women.

Historically, it appears that women in the Philippines had substantial power within their households, particularly in comparison to other women in Asia. Alcantara (1994) and Medina (1991) describe evidence of egalitarian relationships pre-colonization. They also point out that some of women's roles were undermined with the arrival of the Spanish and Christianity. Medina (1991, p. 151) points out that, compared to other Asian women, a Philippine woman has a “relatively high and respected position which dates back to the pre-Spanish era when customary laws gave women the right to be equal to men...”

Women's status in the household may be tied to women's legal standing. Historically, women had little recourse if they were in a problematic marriage. In recognition of the needs of women in marriage, the Family Code (art. 55), enacted in 1988, recognized a host of reasons, including physical violence, as grounds for legal separation (Feliciano, 1994). While today the husband is considered the legal head of the family, in a review of numerous studies, Medina (1991) and David (1994) show that most studies find that joint decision-making is the “norm” in Filipino homes. Even within the norm of joint decisions, there is often a clear division or specialization of men's and women's roles. For example, both Alcantara (1994) and Medina (1991), conclude that women have the power to decide about financial resource allocation and are seen as “treasurers” of the household.

Additional evidence of the norm of joint decision-making with specialization is shown in the work of David (1994) and Alcantara (1994). David (1994) finds that in examining individual domains, decisions about the household budget allocation are consistently dominated by the wife and decisions about family finances and investments are dominated by husbands. The author suggests that these results reflect one member of the couple deferring to the other, who is supposed to have more skills in the area. David (1994) shows that women with more education have more influence in the financial and family planning realm, while education increases husband involvement in the household budget. As for family planning use, men more often have final say, however, David finds that women do not necessarily accept their spouses’ authority. Alcantara (1994) finds similar results to David (1994) using a different data set. Using the domains of resource allocation and fertility, the author finds that decisions are generally made jointly. Surprisingly, these results are not mediated by income or relative income and only moderately associated with women's education. The data also show that parity is a key factor in women's ability to contribute to fertility decisions. A recent study (David, Chin, & Herradura, 1998) in the Western Visayas region of the Philippines shows that IPV is related to women's employment status, with one in three of the working or socially active women surveyed reporting abuse (David et al., 1998).

Based on gender relations in the Philippines, we explore how decision-making is related to IPV. Given the history of joint decision-making, we expect that couples with this “normative” pattern of gender relations are least likely to have IPV. In addition, we expect that in couples where men dominate more of the household decisions, women will experience more IPV due to unequal power relations in the household. Based on the IPV literature in the developing world, it would seem that women who work may be at greater risk of IPV.

The 1993 Demographic and Health Surveys (DHS) included a nationally representative Safe Motherhood Survey on the reproductive health of women in the Philippines, with a series of questions on IPV (National Statistics Office & Macro International, 1994). Nationally, 10% of women reported that someone (including a family member or friend) hit, slapped, kicked or physically harmed them and the highest regional rate (18.9%) was reported in the Central Visayas region, which includes Cebu Province where our study was conducted. Eight percent of the women in the Central Visayas reported that the person who harmed them was their spouse, and most of these women (62%) said that the violence only happened once or twice. The rates for being physically harmed while pregnant were also highest in the Central Visayas (5.5% compared to 2.8% on average). Almost 4% of women in this region report being raped (as compared to almost 3% nationally).

In this paper, a host of factors that could be associated with IPV are considered. In addition to demographic variables, we consider the possible relationship between abuse and household income distribution to assess the possible relationship between women's economic empowerment and IPV. We also consider relationship issues and autonomy in household decision-making. We are particularly interested in the possible link between patterns of household decision-making and abuse since decision-making is a valuable indicator of the interpersonal dynamics between husbands and wives. Household decision-making is thought to be an important factor in a wide range of marital outcomes from fertility related behavior (Mason, 1984; Jejeebhoy, 1995) to women's nutritional well-being (Hindin, 2000a). In particular, we explore how either spouse's domination of household decisions is related to physical abuse of women to determine whether women's empowerment protects against or promotes abuse. We explore these relationships in Cebu, Philippines, where women have an unusually high level of autonomy in decision-making, particularly compared to other women in Asian countries.