ORIGINAL ARTICLE
Domestic Violence Against Women: Systematic Review
of Prevalence Studies
Samia Alhabib & Ula Nur & Roger Jones
Published online: 15 December 2009
# Springer Science+Business Media, LLC 2009
Abstract To systematically review the worldwide evidence
on the prevalence of domestic violence against women, to
evaluate the quality of studies, and to account for variation
in prevalence between studies, using consistent definitions
and explicit, rigorous methods. Systematic review of
prevalence studies on domestic violence against women.
Literature searches of 6 databases were undertaken for the
period 1995 to 2006. Medline, Embase, Cinahl, ASSIA,
ISI, and International Bibliography of the Social Sciences
were searched, supplemented by hand searching of the
reference lists from studies retrieved and specialized
interdisciplinary journals on violence. A total of 134 studies
in English on the prevalence of domestic violence against
women, including women aged 18 to 65 years, but
excluding women with specific disabilities or diseases,
containing primary, empirical research data, were included
in the systematic review. Studies were scored on eight predetermined
criteria and stratified according to the total
quality score. The majority of the sudies were conducted in
North America (41%), followed by Europe (20%). 56% of
studies were population-based, and 17% were carried out
either in primary or community health care settings. There
was considerable heterogeneity both between and within
geographical locations, health care settings, and study
quality The prevalence of lifetime domestic violence varies
from 1.9% in Washington, US, to 70% in Hispanic Latinas
in Southeast US. Only 12% scored a maximum of 8 on
our quality criteria, with 27% studies scored 7, and 17%
scored 6. The mean lifetime prevalence of all types of
violence was found to be highest in studies conducted in
psychiatric and obstetric/gynecology clinics. Results of this
review emphasize that violence against women has reached
epidemic proportions in many societies. Accurate measurement
of the prevalence of domestic violence remains problematic
and further culturally sensitive research is required to
develop more effective preventive policies and programs.
Keywords Domestic violence .Women . Prevalence .
Review
Introduction
Violence against women includes all verbal, physical, and
sexual assaults which violate a woman’s physical body,
sense of self and sense of trust, regardless of age, race,
ethinicity, or country (Campbell 1995). Violence against
women has been identified as a major public health and
human rights issue (Joachim 2000), and has been estimated
by the World Health Organization (WHO) to account for
between 5–20% of healthy years of life lost in women aged
15 to 44 (WHO 1997).
Twenty years ago, violence against women was not
considered an issue worthy of international attention or
concern. This began to change in the 1980s, as women’s
groups were organized locally and internationally to
S. Alhabib (*)
Academic Unit of Primary Health Care, University of Bristol,
25 Belgrave Road,
Bristol BS8 2AA, UK
e-mail: samia.alhabib@bristol.ac.uk
U. Nur
Cancer Statistics-Cancer Research UK,
London School of Hygiene and Tropical Medicine,
London, UK
R. Jones
Department of General Practice & Primary Care,
King’s College London,
London, UK
J Fam Viol (2010) 25:369–382
DOI 10.1007/s10896-009-9298-4
demand attention to the physical, psychological, and
economic abuse of women. Gradually, violence against
women has come to be recognized as a legitimate human
rights issue and a significant threat to women’s health and
well being (Ellsberg and Heise 2005). The process began in
Europe and North America, but even in the United States,
where this trend was most apparent, it took 20 years for
rising awareness to lead to legislation and to potentially
effective preventive measures. Only in the early 1990s were
comprehensive laws enforced and effective resources
allocated to deal with gender violence (Gelles 1997).
Worldwide, domestic violence is as serious a cause of
death and incapacity among women aged 15–49 years as
cancer, and a greater cause of ill health than traffic
accidents and malaria combined (The World Bank 1993).
In addition to causing injury, violence increases women’s
long-term risks of a number of other health problems,
including chronic pain, physical disability, drug and alcohol
abuse, and depression (Heise et al. 1999). Secondary to the
biopsychosocial effects of battering are the high costs of
such violence. Abused women have more than double the
number of medical visits, an 8-fold greater mental healthcare
usage, and an increased hospitalization rate compared
to non-abused women (Wisner et al. 1999). The WHO
multi-country study on women’s health and domestic
violence has recently confirmed significant associations
between lifetime experiences of partner violence and self
reported poor health (Ellsberg et al. 2008).
Prevalence studies of violence against women report
wide variations in levels of violence within and between
health care settings. The reported lifetime prevalence of
physical or sexual violence, or both, varied from 15% to
71% among the countries studied in the WHO multi-country
study (Garcia-Moreno et al. 2006). Few studies have used
standard methods to derive comparative prevalence figures.
The World-Safe initiative represents a successful model that
has been used in five countries (Brazil, Chile, Egypt,
Philippines, and India) to study intimate partner violence
against women and children (Sadowski et al. 2004). The
WHO multi-country study uses another model, which has
been applied in 10 different countries. While confirming that
physical and sexual partner violence against women is
widespread, the variation in prevalence within and between
study settings emphasizes that this violence is not inevitable,
and needs to be addressed.
Over the last 10 years, a number of prevalence surveys on
intimate partner violence has been published from around
the world. However, despite a number of initiatives, such as
the European Network on Conflict, Gender, and Violence, the
launching of a European Society of Criminology and efforts to
develop an international survey on violence against women
(Hagemann-White 2001), information from these studies has
not been systematically collated and analyzed. The aim of
this systematic review is to systematically summarize the
worldwide evidence on the prevalence of domestic violence
against women, to evaluate the quality of studies, and to try
to account for variation in prevalence rates between studies.
Methods
Literature Searches
Parallel literature searches of 6 databases (Medline, Embase,
Cinahl, ASSIA, ISI, and International Bibliography of the
Social sciences) were undertaken for the period1995–2006.
The reference lists from retrieved studies and specilaized
interdisciplinary journals in violence (Violence Against
Women, Journal of Interpersonal Violence) were hand
searched to look for further studies that might not have
been retrieved by the database searches. Authors of
unpublished studies, e.g., PhD theses, were contacted to
obtain copies of their studies. We contacted experts in the
field before and during the process to obtain feedback and
advice with regard to methodology and analysis. All
citations were exported into Reference Manager software
(version 11). Searches included MeSH and text words terms,
with combinations AND OR Boolean operator (Box 1).
Box 1: words used in the search
1. Domestic violence. 13. Frequency.
2. Spouse abuse. 14. Prevalenc$.tw.
3. Battered women. 15. Incidenc$.tw.
4. Partner abuse. 16. Propotion$.tw.
5. Domestic violence.tw. 17. Frequenc$.tw.
6. Spouse abuse.tw. 18. 10 or 11 or 12 or 13 or 14
or 15 or 16 or17.
7. Battered women.tw. 19. Women.
8. Partner abuse.tw. 20. Wom#n.tw.
9. 1 or 2 or 3 or 4 or 5 or 6
or 7 or 8.
21. 19 or 20.
10. Prevalence. 22. 9 and 18 and 21.
11. Incidence. 23. Limit 22 to “all adult
(19 plus years)”
12. Proportion. 24. Limit 23 to female.
We included studies on the prevalence of domestic
violence against women conducted between 1995 and
2006, published in English and including women aged
between 18 and 65 years. We excluded studies on women
with special disabilities or certain complicated diseases e.g.,
HIV, women in places of refuge, case reports, reviews, and
non-English studies. We also excluded studies conducted
on women aged >65 years and on violence against pregnant
370 J Fam Viol (2010) 25:369–382
women, where a large number of studies was found, which
possibly merit a separate review.
Our searches identified 1,653 primary studies, which
were reduced to 356 after screening the titles and abstracts
to assess whether the contents were likely to be within the
scope of the review. We also checked for duplicates
between databases, accounting for 180 (10.9%) of the total
studies. A further 176 studies were excluded because they
were largely naratives about domestic violence cases,
studies of risk factors rather than prevalence or were
predominately review articles. A final total of 134 studies
was selected for further analysis (see Fig. 1).
Quality Assessment
These studies was assessed using structured guidelines
(Loney et al. 2000), and were scored on eight quality
criteria as follows: (1) specification of the target population,
(2) use of an adequate sampling method (e.g., random,
cluster), (3) adequate sample size (>300 subjects), (4)
adequate response rate (>66%), (5) valid, repeatable case
definition, (6) measurment with valid instrument, (7)
reporting of confidence intervals or standard errors, and
(8) attempts to reduce observer bias. We recorded the date of
the study, the prevalence (and/or incidence) estimates of
domestic violence (including life-time and/or current estimates),
and the type of violence reported. These variables
were coded from each study as categorical or continuous.
After quality assessment was completed, studies were
stratified according to the total score from 1–8.
Data Synthesis
The study data were coded and analyzed using SPSS
Version 11. Meta-analyses were conducted in STATA version
10. Continuous & categorical variables were expressed as
frequencies and percentages, and are summarized statistically
in tables and are presented in graphic form. Prevalence
estimates in the figures represent the simple weighted mean
prevalence for all the studies done in each continent.
A number of the studies we have included are described
in more than one publication. In some cases, additional
analysis conducted after completion of a study was reported
in additional publications. In these cases, we used both
reports to inform the data extraction. Conflict in quality
scoring of the included studies was resolved by consensus
between the authors (SA & RJ)
Forest plots were produced to give a graphical representation
of the studies and to convey the extent of heterogeneity
between prevalence estimates. Heterogeneity between prevalence
estimates was tested using a chi-squared test. Sensitivity
analyses were used to determine whether any heterogeneity
found could be due to differing study methodologies, study
quality or geographical differences.
Potentially relevant prevalence
studies identified for retrieval
(n=1653)
Papers excluded on the basis of title & abstract
(n=1297)
Papers retrieved for more detailed
evaluation (n=356)
Papers excluded with reasons (n=180), duplicates
between databases.
Potentially appropriate prevalence
studies to be included in the
review (n=176)
Prevalence studies excluded from review with reasons (n=134),
studies of risk factors, narratives of domestic violence cases, or
review articles.
Prevalence studies included in the
review with usable information
(n=134)
Fig. 1 Flow chart summarising
literature review
J Fam Viol (2010) 25:369–382 371
Results
Most of the studies (41%) were conducted in North America,
followed by 20% in Europe, 16% in Asia, 11% in Africa,
and 5% in the Middle East (Table 1). Eighty three studies
(56%) were population-based, twenty five (17%) were
conducted in primary care, 12% in emergency care settings
and others in obstetrics and gynaecology, paediatric, psychiatric
and other hospital clinics. The sample size was over 300
in 84% of studies. Approximately 60% used a form of
randomisation in their sampling (Table 2). In 41% of studies
a measurement instrument was developed by the researchers
using focus groups or by reference to other validated
measuring instruments, although a few did not report about
the instrument used. The most commonly used instrument
was the Conflict Tactic Scale (16.9%), followed by the
Abuse Assessment Screen (14%) and the WHO instrument
(13%). The most frequently used method of collecting the
data was face-to-face interviews (55%), followed by selfadministered
questionnaires (30%), and telephone interviews
(13%).
Only eighteen studies (12%) scored a maximum of 8 on
our quality criteria, with 33 (27%) studies scoring 7, 25
(17%) scoring 6 (Table 3).
The mean lifetime prevalence for physical, sexual and
emotional violence by country is shown in Fig. 2. The
highest levels of physical violence were seen in Japanese
immigrants to North America (about 47%), who also had
high levels of emotional violence (about 78%) along with
respondents studied in South America, Europe, and Asia
(37–50%).
The mean lifetime prevalence of physical violence was
found to be highest (30–50%) in studies conducted in
psychiatric and obstetric/gynecology clinics (Fig. 3). The
highest rates of sexual violence were found in studies
conducted in psychiatric, obstetric, and gynecology clinics
(30–35%) and, for emotional violence, the highest rates
Table 1 Summary of frequencies of settings and continents
Frequency %
Geographical setting
60 studies in North America 40.5
29 studies in Europe 19.6
23 studies in Asia 15.5
16 studies in Africa 10.8
8 studies in Middle East 5.4
5 studies in Australia 3.4
4 studies in South America 2.7
Healthcare setting
83 Population studies 56.1
25 studies primary care 16.9
18 studies in emergency care 12.2
8 studies in Obst/Gyn clinic 5.4
5 studies in hospital setting 3.4
3 studies in pediatric clinic 2
2 studies in psychiatric clinic 1.4
2 studies in college students 1.4
One study in surgical clinic 0.7
One study in HMO 0.7
Methods
80 population cross-sectional studies 54.1
57 clinical cross-sectional studies 38.5
5 clinical cohort studies 3.4
4 population cohort studies 2.7
Table 2 Summary of frequencies of sampling, methods, and instruments
used
Frequency %
Sampling
124 studies >300 sample size 83.8
24 studies <300 sample size 16.2
88 studies used randomization 59.5
54 studies used other methods 36.5
Instruments
60 studies used their own instrument 40.5
25 studies used CTS 16.9
21 studies used AAS 14.2
19 studies used WHO instrument 12.8
6 studies used PVS 4.1
4 studies used ISA 2.7
3 studies used NorAQ 2
2 studies used women’s health questionnaire 1.4
One study used DVI 0.7
One study used SVAWS 0.7
One study used BRFSS 0.7
One study used WorldSAFE 0.7
Contact with subjects
82 studies used face-to-face interview 55.4
44 studies used self-administered 29.7
19 studies used telephone interview 12.8
Frequency %
18 studies scored 8 12.2
33 studies scored 7 22.3
25 studies scored 6 16.9
34 studies scored 5 23
27 studies scored 4 18.2
8 studies scored 3 5.4
One study scored 2 0.7
2 studies scored 1 1.4
Table 3 Summary of frequencies
of qulaity score
372 J Fam Viol (2010) 25:369–382
were found in accident and emergency and psychiatric
departments (65–87%).
Forest plots of prevalence estimates and their confidence
intervals indicate that there is a large amount of heterogeneity
between studies. Heterogeneity was formally tested
and confirmed by using the chi-squared test. This test
showed strong evidence of heterogeneity (p<0.001). Sensitivity
analyses found that even in studies that: used a
standardized methodology (WHO), scored high in their
quality criteria, were population-based (Fig. 3, 4, 5, and 6),
and in studies that were done in the same continents
(Dickers 2002), heterogeneity was a constant finding.
Pooled estimates across geographical locations and settings
were not calculated due to the extreme heterogeneity and
the difficulty in interpreting them.
Discussion
The results of this review emphasize that violence against
women has reached epidemic proportions in many societies
and suggests that no racial, ethnic, or socio-economic group
is immune. However, we have also highlighted substantial
differences in methodologies, sample sizes, sampling
periods, study populations, and the types of violence
studied. For all types of violence there was a consistent
and a significant heterogeneity between studies, even in
studies that appeared to use standardized methods (e.g.,
WHO multi-country study), population studies, and studies
that scored high on our quality criteria. Age, ethnicity, and
socioeconomic status were not consistently documented,
making comparisons and evaluations of generalizability
difficult. However, the WHO Multi-country study was an
important attempt to collect internationally comparable
statistics through the use of standardized survey methods.
Prevalence of violence has been assumed to be higher in
clinical settings than in population samples (Campbell 2002),
because it is assumed that health care utilization is higher
among victims of abuse (Plichta 1992). For example, high
prevalence rates have been measured in specific patient
groups, for example at gynecology clinics in patients with
severe premenstrual syndrome (PMS) or pelvic pain (Golding
et al. 2000, Walling et al. 1994). This observation is consistent
with the findings in our review, where the highest
figures for violence were found in psychiatric, obstetrics and
gynecology, and emergency clinic settings.
Our review highlights several important factors involved
in the epidemiology of domestic violence against women.
1) Surveys may not measure the actual number of women
who have been abused, but rather, the number of
women who are willing to disclose abuse. As with all
self-reported disclosure, it is possible that results are
biased by either over-reporting or under-reporting. In
most studies, however, little evidence of over-reporting
has been found (Koss 1993).
2) The meaning of violence varies from culture to culture,
and sometimes within the same culture (Krauss 2006).
Women from Asian cultures are brought up in a belief
system that stresses the greater need of the family over the
needs of individual members (Rydstrom 2003). Although
women in the poorest of nations are probably most
inclined to believe that men are justified in beating their
wives, in all settings, in developed and developing
countries, abused women tend to hold more beliefs which
justify violence against them (Fagan and Browne 1994).
Fagan and Browne point out that, in classifying
respondents as victims, a particular interpretation is placed
on these responses, which may ignore important differences
in the interpretation of ‘assault’ and of behaviors which
0 20 40 60 80
Asia
Africa
Europe
South America
North America
Australia
Middle East
Chinese American
Japanese American
American Indian
mean of prevpl mean of prevsl
mean of prevel
Fig. 2 Mean of lifetime prevalence of physical, sexual, and emotional
violence by continent or country. Note: prevpl=prevalence of life time
physical violence, prevel=prevalence of life time emotional violence,
prevsl=prevalence of life time sexual violence
0 20 40 60 80 100
population based
primary/community health
hospital
ED
OBST/GYN
pediatric
psychiatric
HMO
college students
surgery clinic
mean of prevPL mean of prevSL
mean of prevEL
Fig. 3 Mean of lifetime prevalence of physical, sexual, and emotional
violence by setting. Note: prevpl=prevalence of life time physical
violence, prevel=prevalence of life time emotional violence, prevsl=
prevalence of life time sexual violence
J Fam Viol (2010) 25:369–382 373
constitute violence. However, not all women who suffer
abuse identify with the socially constructed image of a
‘battered woman (Mahoney 1991). It is not only important
to learn whether respondents have experienced any of the
particular behaviors that we define as violent or abusive, but
also to understand to what degree they share these labels
with us. Many important social, political, and economic
factors affect women’s lives, other than the cultural practices
that receive so much attention in relation to violence. These
include poverty, inequalities, new articulations of patriarchies
in specific regions, and the legacies of colonialism and
racism (Sokoloff and Pratt 2005).
In Arab and Islamic countries, domestic violence is not
yet considered a major concern, despite its increasing
frequency and serious consequences. Domestic violence
may be seen as a private matter and a potentially justifiable
response to misbehavior on the part of the wife. Selective
excerpts from religious tracts have been inappropriately
used to endorse violence against women, although abuse is
more likely to be a result of culture than of religion (Douki
et al. 2003). However, issues of power and gender (Caetano
et al. 2000), rather than ethnicity and race (Anderson 1997),
may be more important in creating and maintaining male
dominance and the imbalance of power between husbands
and wives (Harris et al. 2005).
Indeed, definitions of race and ethnicity are themselves
problematic in research of this kind. Diverse ethnic groups are
often collapsed into a single category, such as Asians, or the
patterns of a single group such as Mexican Americans are over
generalized to all Hispanics (Campbell et al. 1997). Because
of this, data on partner violence among minority populations
are often incomplete, precluding meaningful generalizations.
3) The measurement of domestic violence, and the accuracy
of its reporting, are both fraught with problems, and
much further work is need in this area. The choice of
Garcia-Moreno C et al Bangladish 2006
Garcia-Moreno C et al Brazil 2006
Garcia-Moreno C et al Ethiopia 2006
Garcia-Moreno C et al Japan 2006
Garcia-Moreno C et al Namibia 2006
Garcia-Moreno C et al Peru 2006
Garcia-Moreno C et al Samoa 2006
Garcia-Moreno C et al Serbia 2006
Garcia-Moreno C et al Thailand 2006
Garcia-Moreno C et al Tanzania 2006
Hicks MHR et al 2006
Yang MS et al 2006
McCloskey LA et al 2005
Romito P et al 2005
Serquina-Ramiro L 2004
Salena H 2004
Eisikovits Z et al 2004
Ghazizadeh A 2005
op-Sidibe N et al 2006
Jain D et al 2004
Naved R.T et al 2006
Khawaja.M & Barazi.R 2005
Ramiro.L.S et al 2004 (Egypt)
Ramiro.L.S et al 2004 (Philippine)
Ramiro.L.S et al 2004 (Chile)
Ramiro.L.S et al 2004 (India)
Jewkes.R et al 2002
Raj A & Silverman.J.G 2002
Jewkes.R et al 2001/a
Jewkes.R et al 2001/b
Jewkes.R et al 2001/c
Ellsberg.M.C et al 1999
Deyessa.N et al 1998
CDC, Georgia 1998
Hakimi et al 2001
study_id
ES (95% CI)
19.00 (17.08, 20.92)
8.30 (6.72, 9.88)
29.00 (27.38, 30.62)
3.10 (2.18, 4.02)
15.90 (14.05, 17.75)
16.90 (14.95, 18.85)
17.90 (16.04, 19.76)
3.20 (2.30, 4.10)
7.90 (6.55, 9.25)
14.80 (13.17, 16.43)
3.00 (0.51, 5.49)
10.10 (7.93, 12.27)
16.20 (14.30, 18.10)
19.00 (15.27, 22.73)
29.00 (26.19, 31.81)
70.00 (64.89, 75.11)
6.00 (4.78, 7.22)
15.00 (12.80, 17.20)
47.00 (45.79, 48.21)
24.00 (20.26, 27.74)
19.00 (17.52, 20.48)
17.40 (12.81, 21.99)
10.50 (8.11, 12.89)
6.20 (4.71, 7.69)
3.60 (1.82, 5.38)
25.30 (22.12, 28.48)
9.50 (7.91, 11.09)
26.60 (19.75, 33.45)
10.90 (7.83, 13.97)
11.90 (8.80, 15.00)
4.50 (2.61, 6.39)
27.00 (23.06, 30.94)
10.00 (7.73, 12.27)
6.00 (5.17, 6.83)
2.00 (1.01, 2.99)
0 10 20 30 40 50 60 70 80 90100
Fig. 4 Forest plot of current
physical violence studies
374 J Fam Viol (2010) 25:369–382
measures and the methodology used to establish the
prevalence of domestic violence have significant impacts
on the prevalence rates there are reported (Waltermaurer
2005). In our study, face-to-face interview methods
yielded more disclosures of violence than self-reported
or telephone interviews, in accordance with previous
research indicating that the use of multiple and openended
questions increases accurate reporting (Hamby et
al. 1996). Written screening alone probably underestimates
the prevalence of intimate partner violence
(McFarlane et al. 1991).
Our results indicate that prevalence of all types of
violence has increased over time, despite the provision of
legal services for victims of violence. International law,
particularly the Convention on the Elimination of All
Forms of Discrimination against Women (Merry 2003) is
a law without sanctions, so that its implementation can
easily be avoided, and traditional interpersonal relationships
within societies can continue to provide conditions which
perpetuate the use of violence (Khawaja and Barazi 2005;
Michalski 2004).
While we have attempted to follow a rigorous protocol
in the conduct of this review, it is still subject to a number
of limitations. It may be prone to indexing bias, publication
bias and reporting bias. Our ability to assess quality of the
studies that we identified was limited by the methodological
information provided in the published articles, some of
which was incomplete.
Conclusion
The high prevalence rates of violence experienced by
women suggests that doctors practicing in all areas of
medicine need to recognize and explore the potential
relevance of violence issues when considering women’s
reasons for presenting with ill health. Sensitization to the
problem of domestic violence should be incorporated not
only in medical training, but into govermental, legal, and
judicial organizations. Inconsistences in methodology identified
in the study emphasize the importance of developing
clearer definitions so that findings can be compared across
settings, to allow more accurate comparasions of prevalence
rates over time, and between different population groups.
Future research should seek to recognize cultural differences
in family functioning without necessarily viewing such
differences as ‘deviant’ or ‘pathological’, and should recog-
Garcia-Moreno C et al Bangladish 2006
Garcia-Moreno C et al Brazil 2006
Garcia-Moreno C et al Ethiopia 2006
Garcia-Moreno C et al Japan 2006
Garcia-Moreno C et al Namibia 2006
Garcia-Moreno C et al Peru 2006
Garcia-Moreno C et al Samoa 2006
Garcia-Moreno C et al Serbia 2006
Garcia-Moreno C et al Thailand 2006
Garcia-Moreno C et al Tanzania 2006
Hicks MHR et al 2006
Yang MS et al 2006
McCloskey LA et al 2005
Romito P et al 2005
Serquina-Ramiro L 2004
Salena H 2004
Eisikovits Z et al 2004
Ghazizadeh A 2005
op-Sidibe N et al 2006
Jain D et al 2004
Naved R.T et al 2006
Khawaja.M & Barazi.R 2005
Ramiro.L.S et al 2004 (Egypt)
Ramiro.L.S et al 2004 (Philippine)
Ramiro.L.S et al 2004 (Chile)
Ramiro.L.S et al 2004 (India)
Jewkes.R et al 2002
Raj A & Silverman.J.G 2002
Jewkes.R et al 2001/a
Jewkes.R et al 2001/b
Jewkes.R et al 2001/c
Ellsberg.M.C et al 1999
Deyessa.N et al 1998
CDC, Georgia 1998
Hakimi et al 2001
study_id 19.00 (17.08, 20.92)
8.30 (6.72, 9.88)
29.00 (27.38, 30.62)
3.10 (2.18, 4.02)
15.90 (14.05, 17.75)
16.90 (14.95, 18.85)
17.90 (16.04, 19.76)
3.20 (2.30, 4.10)
7.90 (6.55, 9.25)
14.80 (13.17, 16.43)
3.00 (0.51, 5.49)
10.10 (7.93, 12.27)
16.20 (14.30, 18.10)
19.00 (15.27, 22.73)
29.00 (26.19, 31.81)
70.00 (64.89, 75.11)
6.00 (4.78, 7.22)
15.00 (12.80, 17.20)
47.00 (45.79, 48.21)
24.00 (20.26, 27.74)
19.00 (17.52, 20.48)
17.40 (12.81, 21.99)
10.50 (8.11, 12.89)
6.20 (4.71, 7.69)
3.60 (1.82, 5.38)
25.30 (22.12, 28.48)
9.50 (7.91, 11.09)
26.60 (19.75, 33.45)
10.90 (7.83, 13.97)
11.90 (8.80, 15.00)
4.50 (2.61, 6.39)
27.00 (23.06, 30.94)
10.00 (7.73, 12.27)
6.00 (5.17, 6.83)
2.00 (1.01, 2.99)
ES (95% CI)
0 102030405060708090100
Fig. 5 Forest plot of prevalences
of current physical violence
from population studies
J Fam Viol (2010) 25:369–382 375
nize the complex nature of differences between and within
ethnic groups. More concentrated and culturally sensitive
research can lead to a clearer understanding of the scope and
causes of violence against women, which in turn may lead to
more effective preventive and intervention efforts.
What is already known on this topic:
• Domestic violence is increasingly recognized as a global health issue.
• In the past decade a number of prevalence surveys on intimate
partner violence have been performed.
• Widely different estimates of the prevalence of domestic violence
have been reported in different settings, suggesting a need to
standardize the methodology used in such research.
What this study adds:
• Violence against women has reached epidemic proportions in most
societies.
• This review identified major differences in methodology,
instruments, sample size, period covered, the population surveyed
and types and forms of violence studied.
• In all types of violence our meta-analysis indicated significant
heterogeneity between studies, even in studies employing standardized
methods.
• To accurately estimate the prevalence of violence in different
settings, researchers need to develop clear and consistent definitions
to allow comparisons between settings.
• prevalence of lifetime domestic violence varies from 1.9% in
Washington, US, to 70% in Hispanic Latinas in Southeast US.
Acknowledgements We would like to acknowledge the advice
given by Dr. Kalwant Sidhu, Director of the MSc Programme at
King’s College London, Martin Hewitt, who provided advice on
literature searching, Dr. Paul Seed, who provided statistical advice,
Prof. Gene Feder and Prof. Tony Ades for commenting on the paper
before submission for publication and to Jeremy Nagle in the British
Library, who helped to track down references.
Contributorship Samia Alhabib had the original idea for the study
which was refined by Roger Jones. Data collection, critical appraisal of
studies and general data analysis were undertaken by Samia Alhabib.
Meta-analysis and sensitivity analysis were undertaken by Ula Nur.
Samia Alhabib and Roger Jones drafted and finalized the manuscript.
Potential Conflict of Interest None declared.
Ethics Approval Not required.
Funding None
Kocacik F et al 2006
Garcia-Moreno C et al Bangladish 2006
Garcia-Moreno C et al Brazil 2006
Garcia-Moreno C et al Ethiopia 2006
Garcia-Moreno C et al Japan 2006
Garcia-Moreno C et al Namibia 2006
Garcia-Moreno C et al Peru 2006
Garcia-Moreno C et al Samoa 2006
Garcia-Moreno C et al Serbia 2006
Garcia-Moreno C et al Thailand 2006
Garcia-Moreno C et al Tanzania 2006
Xu X 2005
Sethi D 2004
Ruiz-Perez I 2006
Michelle Hynes et al 2004
XU X et al 2001
Fanslow.J and Robinson.E 2004
Hakimi et al 2001
study_id
38.25 (34.31, 42.20)
39.68 (37.28, 42.07)
27.13 (24.59, 29.68)
48.67 (46.89, 50.46)
12.84 (11.07, 14.61)
30.60 (28.27, 32.93)
48.59 (45.98, 51.19)
40.49 (38.11, 42.86)
22.80 (20.65, 24.96)
22.92 (20.81, 25.02)
32.86 (30.70, 35.02)
42.95 (39.02, 46.88)
34.85 (28.21, 41.49)
22.75 (18.64, 26.86)
24.91 (19.93, 29.90)
38.00 (34.12, 41.88)
16.98 (15.03, 18.94)
10.98 (8.76, 13.20)
ES (95% CI)
0 10 20 30 40 50 60 70 80 90100
Fig. 6 Forest plot of high
quality studies on life time
prevalence of physical
violence
376 J Fam Viol (2010) 25:369–382
Study ID Population % & Violence type sampling Sample size Response Case definition instrument CI ?Bias Score
Hakim et al. 2001, population study Indonesia (Java) P (LT: 11%, C: 2%), S (LT: 22%, C:
13%), E (LT: 34%, C: 16%)
? 765 94% Yes WHO interview Yes Yes 7
Hynes et al. 2004, population study East Timor Current, P; 24.8% (19.9–29.8), E;
30.5% (22.2–38.8), S; 15.7% (8.6–
22.8)
Random 288 74% Yes WHO interview Yes Yes 7
Haj-Yahia et al. 2000, population
study
Palestine Annual incidence; E; 52%,P; 52%,
S; 37.6%, EC; 45%
Random 2,800, 1,500 86.7%, 88.9% Yes CTS & ISA, Self-administered No No 6
Nikki et al. 2000, community clinic Latin Current overall prevalence; 19% Non-random 1,001 ? Yes ?AAS, interview No No 4
Naved et al. 2006, population study Bangladesh LT prevalence P; 39.7% (Urban),
41.7% (Rural), current P; 19%
(Urban), 15.8% (Rural),
Random 2,702 96% Yes CTS, interview No Yes 7
Mousavi et al. 2005, population
study
Iran LT overall; 36.8%, Incidence;
29.3%, P; 27.2%, E; 32.4%
Random 386 87.5% No Others, interview No Yes 5
Fawole et al. 2005, population study Nigeria P; Current 31.3% Random 431 ? No Others, self-administered No Yes 4
Khawaja and Barazi 2005,
population study
Jordan LT P; 42.5%, C; 17.4% Random 262 (women) 95% Yes Others, interview No No 4
Seedat et al. 2005, population study U.S LT P; 16% Random 637 71% No Others, telephone interview No Yes 5
Amar and Gennaro 2005, college
students
U.S P; C; 48% Non-random 863 ? Yes AAS, self-reported No No 4
Koziol-McLain et al. 2004, ED New Zealand P; C; 21.3%, LT; 44.3% Random 174 60% Yes interview Yes Yes 6
Fanslow and Robinson 2004,
population study
New Zealand LT P, (Auckland); 15%, 17% (North
Waikato) S: 9% in Auckland, 12%
in North Waikato.
Random 2,855 66.9% Yes WHO interview Yes Yes 8
Ramiro et al. 2004, population study Egypt, India, Philippine, Chile LT; (P): (Egypt); 11.1%, India=
34.6%, Philippines = 21.2%,
Chile= 24.9%
Random 422 (Chile), 631
(Egypt), L; 506, T;
700, V; 716, 1,000
(Philippines),
Brazil=813
96.1%(Chile),
93.5%(Egypt),
88%(India),
100%
(Philippine)
Yes Developed by researchers using
focus group, interview
Yes Yes 7
C; (P): Chile= 3.6%, Egypt=10.5%,
India=25.3%, Philippines= 6.2%
LT; E; Chile= 50.7%, Egypt=
10.5%, India=24.9%,
Philippines=19.3%.
C; E; Chile=15.2%, Egypt=10.8%,
India=16.2%, Philippines=4.8%
Swahnberg K et al. 2004, Gyn. clinic Sweden LT E; 16.8, P; 32.1%, S; 15.9%, non-random 2,439 81% Yes NorAQ No Yes 6
Koenig et al. 2004, population study Uganda LT coercive sex; 24% ? 4,279 93% Yes Interview, other methods No Yes 5
? Swahnberg I M et al. 2003,
population study
Sweden, validation study of
NorAQ
LT P; 36.4%, S; 16.9%, E; 21.4% random 1,168 61% Yes NorAQ Yes Yes 7
Grande et al. 2003, population study South Australia LT P; 16%, E; 19% random women=2,884 73.1% Yes Others, telephone survey Yes Yes 8
Harwell et al. 2003, population study American Indian C P; 5%, E; 18%, LT for both; 12% random women=588 94% Yes Others, telephone survey No Yes 6
Murty et al. 2003, population study Iowa C P; 2.9%, E; 46.7% random 689 67.1% Yes CTS, interview No Yes 7
? Bensley et al. 2003, population
study
Washington C P; 1.9%, E; 5.1% random 3,527 57% Yes BRFSS Yes Yes 7
Maziak and Asfar 2003, primary
care.
Syria C P; 23% random 411 97% Yes Others, interview No Yes 6
El-Bassel et al. 2003, ED New York, American Latin C P, 15%, S; 6%, LT P; 43%, S;
20%
Non-random 143 Not reported No Others, interview No No 1
Llika et al. 2002, primary care center Nigeria C overall; 40%, P; 15.8%, E; 20.1% random 300 100% Yes Others, interview No No 5
Okemgbo et al. 2002, population
study
Nigeria LT P; 78.7, %, S; 21.3%, Mutilation;
52.7%
Random 308 Not reported Yes Others, interview No No 4
Basile 2002, population study U.S LT S; 34% Random 602 50% Yes Others, telephone survey No No 4
? Coker et al. 2002, population study U.S LT P; 13.3%, S; 4.3%, E; 12.1%. Random 6,790 72.1% Yes CTS, telephone survey Yes No 7
Jewkes et al. 2002, population study South Africa LT P; 24.6%, Current; 9.5% Random 1,306 90.3% Yes Others, interview Yes Yes 7
Appendix
Summary Table of the include studies:
J Fam Viol (2010) 25:369–382 377
az-Olavarrieta et al. 2002, Hospital
study
Mexico P and/or S; C; 9%, LT; 26.3%. Non-random 1,780 71.9% Yes Self-administered,, AAS No No 5
Coker et al. 2002, family practice South Carolina LT P; 41.8%, S; 21.4%, E; 12.1%. ? 1,152 73% Yes Interview, ISA- to measure the
severity of physical + AAS,
web Scale for E,
No Yes 6
Melnick et al. 2002, surgical trauma
clinic
U.S C P; 18% Not-reported 127 Not-reported Yes PVS, self-administered Yes Yes 5
Romito and Gerin 2002, ER
+Community center
Italy C P and/or S; 10.2% Non-random 510 76% Yes Others, interview No Yes 5
Raj and Silverman 2002, population
study
South Asian women in Boston C P; 26.6%, S; 15%, LTP;30.4%, S;
18.8%
Snowball? 160 Not-reported Yes CTS, self-administered No No 3
Brokaw et al. 2002, ED New Mexico LT P; 47.3% Random 421 67.1% No Others, interview No Yes 5
Krishnan et al. 2001, ED U.S LT P; 72%, S; 20%, E; 92% Non-random 87 70% No Others, interview No No 2
Grynbaum et al. 2001, primary care Israel C P; 21.7%, Incidence; 10% Non-random 133 95.7% No PVS, self-administered No No 3
Barnes et al. 2001, University
students
African American LT P; 15.6%, E; 11.7% random 179 47% Yes ISA, self-administered No No 4
Weinbaum et al. 2001, population
study
California C P; 6% random 3,408 70% Yes CTS, telephone survey Yes No 7
Parkinson et al. 2001, Paediatric
clinic
Massachusetts C P; 2.5%, LT; 16.5%. Non-random 553 71.2% No Others, self-administered Yes No 4
Coid et al. 2001, primary care London LT P; 41%, S; 9% Non-random 1,207 55% Yes Others, self-administered No No 3
Subramaniam and Sivayogan 2001,
community health center
Sri Lanka LT P; 30%, C; 22% random 417 55% Yes Others, interview No Yes 5
Jewkes et al. 2001, population study South Africa 1) Eastern Cape (n=396): LT P;
26.8%, C P; 10.9%, LT S; 4.5%,
C E; 51.4%.
random 1,306 90.3% Yes Others, interview Yes Yes 7
2) Mpumalanga: (n=419), LT P;
28.4%, C; 11.9%, LT S; 7.2%, C
E; 50%.
3) Northern Province: (n=464); LT
P; 19.1%, C; 4.5%, C E; 39.6%
Plichta and Falik 2001, population
study
U.S LT P; 19.1%, S; 20.4% ? 1,821 ? Yes CTS Yes No 5
Bauer et al. 2000, primary care California 1) C P; 10%, S;3%, E; 10%, random 734 74% Yes AAS, telephone survey No No 6
2) LT P; 45%, S; 17%, E; 34%
Harwell and Spence 2000,
population study
Montana C P; 3% random 1,017 90% Yes Others, telephone interview Yes Yes 7
Coker et al. 2000, population study south Carolina LT P; 10.6%, S; 7.8%, E; 7.4% random women=314 69.4% Yes ASS, telephone survey Yes Yes 8
Caetano et al. 2000, population
study
U.S couples C P black; 23%, Hispanic; 17%,
whites; 12%
random White=555,
Black=358,
Hispanic=527
85% Yes CTS, interview No No 6
? CDC 2000, population study. South Carolina LT P; 10.6%, E; 7.4%, S; 7.8% random 313 women 69.4% Yes AAS, telephone survey Yes No 7
? CDC 2000, population study. Washington LT P; 23.6% random 2,012 women 61.4% Yes CTS, telephone survey Yes No 6
Coker et al. 2000, family practice South Carolina LT P; 40%, E; 13.6%, C P; 8.9%, E;
7.5%
Non-random 1,152 73% Yes Interview, ISA to measure
current abuse, WEB to assess
battering, AAS to measure
life-time abuse
No Yes 6
Coker et al. 2000, family practice Columbia LT P; 32%, S;17.3%, E; 12.5%, C P;
18.9%, S; 14.4%,
? 1,401 89% Yes Interview, ISA; for current S
&P, WEBS; for battering,
ASS; for life-time
No No 5
Ernst et al. 2000, ED U.S C P; 5%, LT; 38.6% ? Random 57 78% Yes Self-reported, ISA No Yes 5
Ellsberg et al. 1999, population
study
Nicaragua LT P; 40%, C; 27% ? 488 100% Yes CTS, Interview Yes Yes 7
Tollestrup et al. 1999, population
study
Mexico C P; 6.7%, E; 13.5 Random 2,415 75 Yes CTS, telephone survey No Yes 7
Deyessa et al. 1998, population
study
Ethiopia LT P; 45% (n=303), C; 10% Random 673 ? Yes Others, interview No Yes 5
Kershner et al. 1998, community
clinic
Minnesota LT P; 37%, C P; 6.6%, E; 21.1%, S;
2.1%,
Non-random 1,693 82.4% Yes Others, self-administered No Yes 5
? CDC 1998, population study Georgia C P; 6%, LT; 30% Random 3,130 78% Yes Others, telephone survey Yes No 6
Pakieser et al. 1998, ED Texas LT P; 37%, C; 10%. Non-random 4,448 40% Yes Others, self-administered No No No
378 J Fam Viol (2010) 25:369–382
Sachs et al., ED California LT P; 14.7%, C; 3.9% Non-random 480 women 66.2% Yes Others, self-administered Yes No 5
Magdol et al. 1997, population study New Zealand C P; 27.1%, E; 83.8%
Schei et al. 2006, population study Australia LT P/E/S; 27.5% Random 356 90% Yes CTS, interview No No 6
Yuan et al. 2006, population study Native American LT P;45%,S; 14% Random 793 98% Yes Others, interview No No 5
Avdibegovic et al. 2006, psychiatric
clinic
Bosnia and Herzegovina LT,P; 75.9%, P & S; 43.5%, E;
85.6%
Random 283 89.5% Not reported DVI, interview No No 4
Kocacik et al. 2006, population
study
Turkey LTE; 53.8%, P 38.3%, S;7.9% random 583 100% Not reported WHO, interview No No 5
WHO, Garcia-Moreno et al. 2006,
population study
Bangladesh, Brazil, Ethiopia,
Japan, Namibia, Peru, Samoa
(National), Serbia, Thailand,
Tanzania,
Bangladesh: LT (P:39.7%,
S:37.4%), C (P19%,S:20.2%)
random 24,097 Japan (60.2%),
other countries
range; 85–
97.8%
Yes Interview, built on CTS Yes Yes 8, in
Japan=7
2-Brazil: LT (P27.2%,S 10.2%), C
(P8.3%,S 2.8%).
3. Ethiopia: LT (P48.7%, S 58.6%),
C (P29%, S 44.4%).
4. Japan; LT (P12.9%, S 6.2%), C
(P3.1%, S 1.3%).
5. Namibia: LT (P30.6%,S 16.5%),
C(P15.9%,S9.1%).
6. Peru: LT (P48.6%,S 22.5%), C
(P16.9%, S 7.1% ).
7. Samoa: LT (P40.5%, S 19.5%),
C (P17.9%, S 11.5%).
8. Serbia: LT (P22.8%, S 6.3%), C
(P3.2%, S 1.1%).
9. Thailand: LT (P22.9%, S
29.9%), C(P7.9%, S 17.1%).
10. Tanzania: LT (P32.9%, S 23%),
C (P14.8%, S 12.8%).
Hicks et al. 2006, population study Chinese American LT P;13%, C; 3%, random 323 56% Yes CTS, interview Yes Yes 7
Yang et al. 2006, population study Taiwanese aboriginal tribes LT prevalence P; 15%, C; 10.1%, S:
4%
random 876 84.7% No ASS, interview Yes No 6
Thompson et al. 2006, population
study
Washington LT prevalence (P; 44%, S: 30.3%,
E: 35.1%)
random 3,568 56.4% Yes WEB, telephone survey No No 5
Ruiz-Perez et al. 2006, general
practice
Spain LT prevalence; P: 14.3%, E: 30.8%,
S: 8.9%
Random 1,402 88.35% Yes WHO, self-administrated No No 6
Ergin et al. 2005, primary care Turkey (Bursa) LT P; 34.1%, E; 15.8%, economic;
8.2%, all-type violence; 29.5%
Not reported 1,427 71% Yes AAS, interview No Yes 6
McCloskey et al. 2005, population
study
Mohsi (Tanzania sub-Saharan
Africa)
LT P: 19.7%, S: 3.4%, C: P; 16.2%,
S: 1.4%.
Random 1,444 71% Yes One item from CTS, and 2
items from AAS, one item
from SES, interview
Yes No 7
Overall prevalence: 26%
Bengtsson-Tops 2005, psychiatric
clinic
Sweden LT P; 28%, S; 19%, Economic;
16%; E; 46%.
Non-Random 1,382 79% Yes Others, interview No No 4
C; P; 6%, S;3%, Economic; 6%, E;
22%
Kyu and Kana 2005, population
study
Myanmar (South-East Asia), C; P; 27%, E; 69% Random 286 82% Yes CTS, self-administered No No 5
Burazeri et al. 2005, population
study
Albania C; P; 37% Random 1,196 87% No Others, interview Yes No 5
Mayda and Akkus 2004, population
study
Turkey LT P; 41.4%, E; 25.98%, S; 8.6%,
E; 77.6%
Non-Random 116 100% Yes Others, interview No Yes 4
McFarlane et al. 2005, primary care U.S C P&S; 8.9% in White, 6% in
African American, 5.3% in
Hispanic.
Non random 7,443 Not reported Yes Others? No No 4
Romito et al. 2005, family practice Italy Overall P, S, E, LT: 27.4%, C:
19.9%
Non random 444 78.6% Yes Others, self-administered No No 4
Newman et al. 2005, paediatric ED Chicago C P & S; 11% Non random 461 Not reported Not reported AAS, self-administered No No 3
Hegarty and Bush 2002, general
practice
Australia LT, P: 23.3%, E: 33.9%, S; 10.6% random 2,338 78.5% Yes AAS, self-administered Yes No 6
J Fam Viol (2010) 25:369–382 379
Dal Grande et al. 2003, population
study
Australia LT P; 16%, E; 19%. random 6,004 73.1% Yes Others, telephone interview Yes Yes 7
Xu X et al. 2005, gynecology clinic China (Fuzhou) Overall LT P, S, E; 43%, C; 26% random 685 89% Yes WHO Q, interview Yes No 7
Parish et al. 2004, population study China LT P; 34% random 1,665 women 76% No Others, interview No No 4
John et al. 2004, gynecology clinic North England LT P; 21%, C: 4% Non random 920 90% Yes AAS, self-administered No No 5
Romito et al. 2004, primary care Italy LT P; 14.1%, S; 17.6%, E; 16.4% Non random 542 8.6% Yes Others, Self-administered Yes No 5
C: P; 5.2%, S: 5.2%, E: 19%
Serquina-Ramiro et al. 2004,
population study
Manila LT P; 47.2%, C; 29% Random 1,000 90% Yes WorldSAFE, interview No Yes 7
Rivera- Rivera et al. 2004,
population study
Mexico LT P; 35.8% random 1,641 93.5% Yes CTS, interview Yes Yes 8
Keeling and Birch 2004, Hospital Warral, UK LT ?P: 34.9%, C; 14% Non random 294 99.3% No AAS, self administered Yes No 4
Cox et al. 2004, ED Northern Canada Overall life-time P & E: 51%, C:
26%,
random 1,223 80% Yes Others, interview Yes Yes 8
Incidence: 18%
Kramer et al. 2004, primary care U.S LT: P; 49.5%, S; 265, E; 72%. Non random 1,268 9% in each cell Yes AAS, self administered Yes No 6
C; P; 11.7%, S; 4.2%, E; 27.9%.
Sethi et al. 2004, ER UK Life-time P.; 34.8%, C; 6.1% Non random 228 86.8% Yes WHO Q, interview Yes No 5
Peralta and Fleming 2003, family
medicine
Madison, Wisconsin C; P: 10.3%, E; 43.5% Non random 399 Not reported Yes CTS, self reported No No 4
Ruiz-Perez et al. 2006, primary care Spain LT of any violence; 22.8% Non random 449 89.08% Yes WHO Q, self administered No No 5
Lown et al. 2006, population study California C P; 27.4%, S; 6.7% Non random 1,786 85% Yes CTS, interview Yes Yes 7
Ghazizadeh et al. 2005, population
study
Iran LT P; 38%, C; 15% random 1,040 97% No Others, interview No No
Faramarzi et al. 2005, obstetric/
gynecology clinic
Iran C P; 15%, S; 42.4%, E; 81.5% Non random 2,400 Not clear Yes AAS, interview No No 5
Ahmed and Elmradi 2005, medical
center
Sudan C P & E; 41.6% Non random 492 86.8% Yes Others, self-administered No No 4
Evans-Campbell et al. 2006,
population study
New York LT P; 40% random 112 women 83% No Others, interview No Yes 4
op-Sidibe et al. 2006, population
study
Egypt LT P; 34.3%, C; 47% random 6,566 99% Yes Others, interview No No 5
Apler et al. 2005, primary care Turkey LT P; 58.7%, C P; 41.1%%, E;
33.6%
Non random 506 Not reported Yes AAS, interview No No 4
Coid et al. 2003, general practice Hackney, east London LT S; 24% Non random 1,206 54% Yes Others, self administered Yes No 4
Siegel et al. 2003, pediatric setting U.S Incidence; 6%, LT P; 22%, C: 16% Non random 435 Not reported No Others, self administered No Yes 3
Boyle and Todd 2003, ED Cambridge LT P; 21.3%, C; 6.1%, incidence:
1.2%
random 307 84.8% Yes Others, interview Yes No 5
Shaikh et al. 2003, obstetric/
gynecology clinic
Pakistan LT P; 55.9%, E; 75.9%, S; 46.9% Non random 307 70.4% Yes Others, interview No No 3
Richardson et al. 2002, general
practice
East London LT P:;41%, C; 17%, E; 74% Non random 2,192 64% Yes Others, self administered Yes Yes 6
Bradley et al. 2002, general practice Ireland LT P; 39%, E; 54% Non random 2,615 72% Yes Others, self administered Yes No 5
Mazza et al. 2001, population study Australia Overall LT prevalence; 28.5%, E;
17%, S; 40.8%,
Non random 395 90% Yes CTS, self-administered Yes No 6
Zachary et al. 2001, ED New York C P; 7.9%, LT; 38% Non random 795 76.8% Yes CTS, interview No Yes 6
Az- Olavarrieta et al. 2001, hospital
study
Mexico LT P; 14%, E; overall; 40%, S; 9.3% Non random 1,255 83% Yes Others, elf-administered Yes No 5
Augenbraun et al. 2001, hospital
study
Brooklyn, NY LT P; 37.6%, E; 32.8%, C P;
15.5%, E; 19.1%
Non random 375 96% Yes Others, elf-administered No Yes 5
Lown and Vega 2001, population
study
Fresno County, California C P; 10.7% Random 1,155 90% Yes AAS, self-administered Yes Yes 8
Hedin et al. 2000, gynecology clinic Sweden C; P; 6%, S; 3%, E; 12.5% Non random 207 64% Yes SVAW, self-administered No No 3
Jones et al. 1999, HMO survey Washington DC LT P, S, E; 36.9%, C; 4% Non random 10, 599 14% Yes AAS, self-administered No No 4
Duffy et al. 1999, pediatric ED New England city LT P; 52%, S; 21%, Non random 157 Not reported Yes AAS, interview No Yes 4
Fikree and Bhatti 1999, primary care Pakistan, Karachi LT P; 34% Non random 150 Not reported No Others, interview No No 1
Dearwater et al. 1998, ED Pennsylvania & California LT P/E; 36.9%, C P/S; 14.4% Non random 4,641 74% Yes AAS, self-administered Yes Yes 7
Ernst et al. 1997, ED New Orleans LT non P; 22%, P; 33%, C non-Pl;
15%, current P; 19%
random 283 women 94% Yes ISA, self-administered No No 5
380 J Fam Viol (2010) 25:369–382
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ORIGINAL ARTICLE
Domestic Violence Against Women: Systematic Review
of Prevalence Studies
Samia Alhabib & Ula Nur & Roger Jones
Published online: 15 December 2009
# Springer Science+Business Media, LLC 2009
Abstract To systematically review the worldwide evidence
on the prevalence of domestic violence against women, to
evaluate the quality of studies, and to account for variation
in prevalence between studies, using consistent definitions
and explicit, rigorous methods. Systematic review of
prevalence studies on domestic violence against women.
Literature searches of 6 databases were undertaken for the
period 1995 to 2006. Medline, Embase, Cinahl, ASSIA,
ISI, and International Bibliography of the Social Sciences
were searched, supplemented by hand searching of the
reference lists from studies retrieved and specialized
interdisciplinary journals on violence. A total of 134 studies
in English on the prevalence of domestic violence against
women, including women aged 18 to 65 years, but
excluding women with specific disabilities or diseases,
containing primary, empirical research data, were included
in the systematic review. Studies were scored on eight predetermined
criteria and stratified according to the total
quality score. The majority of the sudies were conducted in
North America (41%), followed by Europe (20%). 56% of
studies were population-based, and 17% were carried out
either in primary or community health care settings. There
was considerable heterogeneity both between and within
geographical locations, health care settings, and study
quality The prevalence of lifetime domestic violence varies
from 1.9% in Washington, US, to 70% in Hispanic Latinas
in Southeast US. Only 12% scored a maximum of 8 on
our quality criteria, with 27% studies scored 7, and 17%
scored 6. The mean lifetime prevalence of all types of
violence was found to be highest in studies conducted in
psychiatric and obstetric/gynecology clinics. Results of this
review emphasize that violence against women has reached
epidemic proportions in many societies. Accurate measurement
of the prevalence of domestic violence remains problematic
and further culturally sensitive research is required to
develop more effective preventive policies and programs.
Keywords Domestic violence .Women . Prevalence .
Review
Introduction
Violence against women includes all verbal, physical, and
sexual assaults which violate a woman’s physical body,
sense of self and sense of trust, regardless of age, race,
ethinicity, or country (Campbell 1995). Violence against
women has been identified as a major public health and
human rights issue (Joachim 2000), and has been estimated
by the World Health Organization (WHO) to account for
between 5–20% of healthy years of life lost in women aged
15 to 44 (WHO 1997).
Twenty years ago, violence against women was not
considered an issue worthy of international attention or
concern. This began to change in the 1980s, as women’s
groups were organized locally and internationally to
S. Alhabib (*)
Academic Unit of Primary Health Care, University of Bristol,
25 Belgrave Road,
Bristol BS8 2AA, UK
e-mail: samia.alhabib@bristol.ac.uk
U. Nur
Cancer Statistics-Cancer Research UK,
London School of Hygiene and Tropical Medicine,
London, UK
R. Jones
Department of General Practice & Primary Care,
King’s College London,
London, UK
J Fam Viol (2010) 25:369–382
DOI 10.1007/s10896-009-9298-4
demand attention to the physical, psychological, and
economic abuse of women. Gradually, violence against
women has come to be recognized as a legitimate human
rights issue and a significant threat to women’s health and
well being (Ellsberg and Heise 2005). The process began in
Europe and North America, but even in the United States,
where this trend was most apparent, it took 20 years for
rising awareness to lead to legislation and to potentially
effective preventive measures. Only in the early 1990s were
comprehensive laws enforced and effective resources
allocated to deal with gender violence (Gelles 1997).
Worldwide, domestic violence is as serious a cause of
death and incapacity among women aged 15–49 years as
cancer, and a greater cause of ill health than traffic
accidents and malaria combined (The World Bank 1993).
In addition to causing injury, violence increases women’s
long-term risks of a number of other health problems,
including chronic pain, physical disability, drug and alcohol
abuse, and depression (Heise et al. 1999). Secondary to the
biopsychosocial effects of battering are the high costs of
such violence. Abused women have more than double the
number of medical visits, an 8-fold greater mental healthcare
usage, and an increased hospitalization rate compared
to non-abused women (Wisner et al. 1999). The WHO
multi-country study on women’s health and domestic
violence has recently confirmed significant associations
between lifetime experiences of partner violence and self
reported poor health (Ellsberg et al. 2008).
Prevalence studies of violence against women report
wide variations in levels of violence within and between
health care settings. The reported lifetime prevalence of
physical or sexual violence, or both, varied from 15% to
71% among the countries studied in the WHO multi-country
study (Garcia-Moreno et al. 2006). Few studies have used
standard methods to derive comparative prevalence figures.
The World-Safe initiative represents a successful model that
has been used in five countries (Brazil, Chile, Egypt,
Philippines, and India) to study intimate partner violence
against women and children (Sadowski et al. 2004). The
WHO multi-country study uses another model, which has
been applied in 10 different countries. While confirming that
physical and sexual partner violence against women is
widespread, the variation in prevalence within and between
study settings emphasizes that this violence is not inevitable,
and needs to be addressed.
Over the last 10 years, a number of prevalence surveys on
intimate partner violence has been published from around
the world. However, despite a number of initiatives, such as
the European Network on Conflict, Gender, and Violence, the
launching of a European Society of Criminology and efforts to
develop an international survey on violence against women
(Hagemann-White 2001), information from these studies has
not been systematically collated and analyzed. The aim of
this systematic review is to systematically summarize the
worldwide evidence on the prevalence of domestic violence
against women, to evaluate the quality of studies, and to try
to account for variation in prevalence rates between studies.
Methods
Literature Searches
Parallel literature searches of 6 databases (Medline, Embase,
Cinahl, ASSIA, ISI, and International Bibliography of the
Social sciences) were undertaken for the period1995–2006.
The reference lists from retrieved studies and specilaized
interdisciplinary journals in violence (Violence Against
Women, Journal of Interpersonal Violence) were hand
searched to look for further studies that might not have
been retrieved by the database searches. Authors of
unpublished studies, e.g., PhD theses, were contacted to
obtain copies of their studies. We contacted experts in the
field before and during the process to obtain feedback and
advice with regard to methodology and analysis. All
citations were exported into Reference Manager software
(version 11). Searches included MeSH and text words terms,
with combinations AND OR Boolean operator (Box 1).
Box 1: words used in the search
1. Domestic violence. 13. Frequency.
2. Spouse abuse. 14. Prevalenc$.tw.
3. Battered women. 15. Incidenc$.tw.
4. Partner abuse. 16. Propotion$.tw.
5. Domestic violence.tw. 17. Frequenc$.tw.
6. Spouse abuse.tw. 18. 10 or 11 or 12 or 13 or 14
or 15 or 16 or17.
7. Battered women.tw. 19. Women.
8. Partner abuse.tw. 20. Wom#n.tw.
9. 1 or 2 or 3 or 4 or 5 or 6
or 7 or 8.
21. 19 or 20.
10. Prevalence. 22. 9 and 18 and 21.
11. Incidence. 23. Limit 22 to “all adult
(19 plus years)”
12. Proportion. 24. Limit 23 to female.
We included studies on the prevalence of domestic
violence against women conducted between 1995 and
2006, published in English and including women aged
between 18 and 65 years. We excluded studies on women
with special disabilities or certain complicated diseases e.g.,
HIV, women in places of refuge, case reports, reviews, and
non-English studies. We also excluded studies conducted
on women aged >65 years and on violence against pregnant
370 J Fam Viol (2010) 25:369–382
women, where a large number of studies was found, which
possibly merit a separate review.
Our searches identified 1,653 primary studies, which
were reduced to 356 after screening the titles and abstracts
to assess whether the contents were likely to be within the
scope of the review. We also checked for duplicates
between databases, accounting for 180 (10.9%) of the total
studies. A further 176 studies were excluded because they
were largely naratives about domestic violence cases,
studies of risk factors rather than prevalence or were
predominately review articles. A final total of 134 studies
was selected for further analysis (see Fig. 1).
Quality Assessment
These studies was assessed using structured guidelines
(Loney et al. 2000), and were scored on eight quality
criteria as follows: (1) specification of the target population,
(2) use of an adequate sampling method (e.g., random,
cluster), (3) adequate sample size (>300 subjects), (4)
adequate response rate (>66%), (5) valid, repeatable case
definition, (6) measurment with valid instrument, (7)
reporting of confidence intervals or standard errors, and
(8) attempts to reduce observer bias. We recorded the date of
the study, the prevalence (and/or incidence) estimates of
domestic violence (including life-time and/or current estimates),
and the type of violence reported. These variables
were coded from each study as categorical or continuous.
After quality assessment was completed, studies were
stratified according to the total score from 1–8.
Data Synthesis
The study data were coded and analyzed using SPSS
Version 11. Meta-analyses were conducted in STATA version
10. Continuous & categorical variables were expressed as
frequencies and percentages, and are summarized statistically
in tables and are presented in graphic form. Prevalence
estimates in the figures represent the simple weighted mean
prevalence for all the studies done in each continent.
A number of the studies we have included are described
in more than one publication. In some cases, additional
analysis conducted after completion of a study was reported
in additional publications. In these cases, we used both
reports to inform the data extraction. Conflict in quality
scoring of the included studies was resolved by consensus
between the authors (SA & RJ)
Forest plots were produced to give a graphical representation
of the studies and to convey the extent of heterogeneity
between prevalence estimates. Heterogeneity between prevalence
estimates was tested using a chi-squared test. Sensitivity
analyses were used to determine whether any heterogeneity
found could be due to differing study methodologies, study
quality or geographical differences.
Potentially relevant prevalence
studies identified for retrieval
(n=1653)
Papers excluded on the basis of title & abstract
(n=1297)
Papers retrieved for more detailed
evaluation (n=356)
Papers excluded with reasons (n=180), duplicates
between databases.
Potentially appropriate prevalence
studies to be included in the
review (n=176)
Prevalence studies excluded from review with reasons (n=134),
studies of risk factors, narratives of domestic violence cases, or
review articles.
Prevalence studies included in the
review with usable information
(n=134)
Fig. 1 Flow chart summarising
literature review
J Fam Viol (2010) 25:369–382 371
Results
Most of the studies (41%) were conducted in North America,
followed by 20% in Europe, 16% in Asia, 11% in Africa,
and 5% in the Middle East (Table 1). Eighty three studies
(56%) were population-based, twenty five (17%) were
conducted in primary care, 12% in emergency care settings
and others in obstetrics and gynaecology, paediatric, psychiatric
and other hospital clinics. The sample size was over 300
in 84% of studies. Approximately 60% used a form of
randomisation in their sampling (Table 2). In 41% of studies
a measurement instrument was developed by the researchers
using focus groups or by reference to other validated
measuring instruments, although a few did not report about
the instrument used. The most commonly used instrument
was the Conflict Tactic Scale (16.9%), followed by the
Abuse Assessment Screen (14%) and the WHO instrument
(13%). The most frequently used method of collecting the
data was face-to-face interviews (55%), followed by selfadministered
questionnaires (30%), and telephone interviews
(13%).
Only eighteen studies (12%) scored a maximum of 8 on
our quality criteria, with 33 (27%) studies scoring 7, 25
(17%) scoring 6 (Table 3).
The mean lifetime prevalence for physical, sexual and
emotional violence by country is shown in Fig. 2. The
highest levels of physical violence were seen in Japanese
immigrants to North America (about 47%), who also had
high levels of emotional violence (about 78%) along with
respondents studied in South America, Europe, and Asia
(37–50%).
The mean lifetime prevalence of physical violence was
found to be highest (30–50%) in studies conducted in
psychiatric and obstetric/gynecology clinics (Fig. 3). The
highest rates of sexual violence were found in studies
conducted in psychiatric, obstetric, and gynecology clinics
(30–35%) and, for emotional violence, the highest rates
Table 1 Summary of frequencies of settings and continents
Frequency %
Geographical setting
60 studies in North America 40.5
29 studies in Europe 19.6
23 studies in Asia 15.5
16 studies in Africa 10.8
8 studies in Middle East 5.4
5 studies in Australia 3.4
4 studies in South America 2.7
Healthcare setting
83 Population studies 56.1
25 studies primary care 16.9
18 studies in emergency care 12.2
8 studies in Obst/Gyn clinic 5.4
5 studies in hospital setting 3.4
3 studies in pediatric clinic 2
2 studies in psychiatric clinic 1.4
2 studies in college students 1.4
One study in surgical clinic 0.7
One study in HMO 0.7
Methods
80 population cross-sectional studies 54.1
57 clinical cross-sectional studies 38.5
5 clinical cohort studies 3.4
4 population cohort studies 2.7
Table 2 Summary of frequencies of sampling, methods, and instruments
used
Frequency %
Sampling
124 studies >300 sample size 83.8
24 studies <300 sample size 16.2
88 studies used randomization 59.5
54 studies used other methods 36.5
Instruments
60 studies used their own instrument 40.5
25 studies used CTS 16.9
21 studies used AAS 14.2
19 studies used WHO instrument 12.8
6 studies used PVS 4.1
4 studies used ISA 2.7
3 studies used NorAQ 2
2 studies used women’s health questionnaire 1.4
One study used DVI 0.7
One study used SVAWS 0.7
One study used BRFSS 0.7
One study used WorldSAFE 0.7
Contact with subjects
82 studies used face-to-face interview 55.4
44 studies used self-administered 29.7
19 studies used telephone interview 12.8
Frequency %
18 studies scored 8 12.2
33 studies scored 7 22.3
25 studies scored 6 16.9
34 studies scored 5 23
27 studies scored 4 18.2
8 studies scored 3 5.4
One study scored 2 0.7
2 studies scored 1 1.4
Table 3 Summary of frequencies
of qulaity score
372 J Fam Viol (2010) 25:369–382
were found in accident and emergency and psychiatric
departments (65–87%).
Forest plots of prevalence estimates and their confidence
intervals indicate that there is a large amount of heterogeneity
between studies. Heterogeneity was formally tested
and confirmed by using the chi-squared test. This test
showed strong evidence of heterogeneity (p<0.001). Sensitivity
analyses found that even in studies that: used a
standardized methodology (WHO), scored high in their
quality criteria, were population-based (Fig. 3, 4, 5, and 6),
and in studies that were done in the same continents
(Dickers 2002), heterogeneity was a constant finding.
Pooled estimates across geographical locations and settings
were not calculated due to the extreme heterogeneity and
the difficulty in interpreting them.
Discussion
The results of this review emphasize that violence against
women has reached epidemic proportions in many societies
and suggests that no racial, ethnic, or socio-economic group
is immune. However, we have also highlighted substantial
differences in methodologies, sample sizes, sampling
periods, study populations, and the types of violence
studied. For all types of violence there was a consistent
and a significant heterogeneity between studies, even in
studies that appeared to use standardized methods (e.g.,
WHO multi-country study), population studies, and studies
that scored high on our quality criteria. Age, ethnicity, and
socioeconomic status were not consistently documented,
making comparisons and evaluations of generalizability
difficult. However, the WHO Multi-country study was an
important attempt to collect internationally comparable
statistics through the use of standardized survey methods.
Prevalence of violence has been assumed to be higher in
clinical settings than in population samples (Campbell 2002),
because it is assumed that health care utilization is higher
among victims of abuse (Plichta 1992). For example, high
prevalence rates have been measured in specific patient
groups, for example at gynecology clinics in patients with
severe premenstrual syndrome (PMS) or pelvic pain (Golding
et al. 2000, Walling et al. 1994). This observation is consistent
with the findings in our review, where the highest
figures for violence were found in psychiatric, obstetrics and
gynecology, and emergency clinic settings.
Our review highlights several important factors involved
in the epidemiology of domestic violence against women.
1) Surveys may not measure the actual number of women
who have been abused, but rather, the number of
women who are willing to disclose abuse. As with all
self-reported disclosure, it is possible that results are
biased by either over-reporting or under-reporting. In
most studies, however, little evidence of over-reporting
has been found (Koss 1993).
2) The meaning of violence varies from culture to culture,
and sometimes within the same culture (Krauss 2006).
Women from Asian cultures are brought up in a belief
system that stresses the greater need of the family over the
needs of individual members (Rydstrom 2003). Although
women in the poorest of nations are probably most
inclined to believe that men are justified in beating their
wives, in all settings, in developed and developing
countries, abused women tend to hold more beliefs which
justify violence against them (Fagan and Browne 1994).
Fagan and Browne point out that, in classifying
respondents as victims, a particular interpretation is placed
on these responses, which may ignore important differences
in the interpretation of ‘assault’ and of behaviors which
0 20 40 60 80
Asia
Africa
Europe
South America
North America
Australia
Middle East
Chinese American
Japanese American
American Indian
mean of prevpl mean of prevsl
mean of prevel
Fig. 2 Mean of lifetime prevalence of physical, sexual, and emotional
violence by continent or country. Note: prevpl=prevalence of life time
physical violence, prevel=prevalence of life time emotional violence,
prevsl=prevalence of life time sexual violence
0 20 40 60 80 100
population based
primary/community health
hospital
ED
OBST/GYN
pediatric
psychiatric
HMO
college students
surgery clinic
mean of prevPL mean of prevSL
mean of prevEL
Fig. 3 Mean of lifetime prevalence of physical, sexual, and emotional
violence by setting. Note: prevpl=prevalence of life time physical
violence, prevel=prevalence of life time emotional violence, prevsl=
prevalence of life time sexual violence
J Fam Viol (2010) 25:369–382 373
constitute violence. However, not all women who suffer
abuse identify with the socially constructed image of a
‘battered woman (Mahoney 1991). It is not only important
to learn whether respondents have experienced any of the
particular behaviors that we define as violent or abusive, but
also to understand to what degree they share these labels
with us. Many important social, political, and economic
factors affect women’s lives, other than the cultural practices
that receive so much attention in relation to violence. These
include poverty, inequalities, new articulations of patriarchies
in specific regions, and the legacies of colonialism and
racism (Sokoloff and Pratt 2005).
In Arab and Islamic countries, domestic violence is not
yet considered a major concern, despite its increasing
frequency and serious consequences. Domestic violence
may be seen as a private matter and a potentially justifiable
response to misbehavior on the part of the wife. Selective
excerpts from religious tracts have been inappropriately
used to endorse violence against women, although abuse is
more likely to be a result of culture than of religion (Douki
et al. 2003). However, issues of power and gender (Caetano
et al. 2000), rather than ethnicity and race (Anderson 1997),
may be more important in creating and maintaining male
dominance and the imbalance of power between husbands
and wives (Harris et al. 2005).
Indeed, definitions of race and ethnicity are themselves
problematic in research of this kind. Diverse ethnic groups are
often collapsed into a single category, such as Asians, or the
patterns of a single group such as Mexican Americans are over
generalized to all Hispanics (Campbell et al. 1997). Because
of this, data on partner violence among minority populations
are often incomplete, precluding meaningful generalizations.
3) The measurement of domestic violence, and the accuracy
of its reporting, are both fraught with problems, and
much further work is need in this area. The choice of
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ES (95% CI)
19.00 (17.08, 20.92)
8.30 (6.72, 9.88)
29.00 (27.38, 30.62)
3.10 (2.18, 4.02)
15.90 (14.05, 17.75)
16.90 (14.95, 18.85)
17.90 (16.04, 19.76)
3.20 (2.30, 4.10)
7.90 (6.55, 9.25)
14.80 (13.17, 16.43)
3.00 (0.51, 5.49)
10.10 (7.93, 12.27)
16.20 (14.30, 18.10)
19.00 (15.27, 22.73)
29.00 (26.19, 31.81)
70.00 (64.89, 75.11)
6.00 (4.78, 7.22)
15.00 (12.80, 17.20)
47.00 (45.79, 48.21)
24.00 (20.26, 27.74)
19.00 (17.52, 20.48)
17.40 (12.81, 21.99)
10.50 (8.11, 12.89)
6.20 (4.71, 7.69)
3.60 (1.82, 5.38)
25.30 (22.12, 28.48)
9.50 (7.91, 11.09)
26.60 (19.75, 33.45)
10.90 (7.83, 13.97)
11.90 (8.80, 15.00)
4.50 (2.61, 6.39)
27.00 (23.06, 30.94)
10.00 (7.73, 12.27)
6.00 (5.17, 6.83)
2.00 (1.01, 2.99)
0 10 20 30 40 50 60 70 80 90100
Fig. 4 Forest plot of current
physical violence studies
374 J Fam Viol (2010) 25:369–382
measures and the methodology used to establish the
prevalence of domestic violence have significant impacts
on the prevalence rates there are reported (Waltermaurer
2005). In our study, face-to-face interview methods
yielded more disclosures of violence than self-reported
or telephone interviews, in accordance with previous
research indicating that the use of multiple and openended
questions increases accurate reporting (Hamby et
al. 1996). Written screening alone probably underestimates
the prevalence of intimate partner violence
(McFarlane et al. 1991).
Our results indicate that prevalence of all types of
violence has increased over time, despite the provision of
legal services for victims of violence. International law,
particularly the Convention on the Elimination of All
Forms of Discrimination against Women (Merry 2003) is
a law without sanctions, so that its implementation can
easily be avoided, and traditional interpersonal relationships
within societies can continue to provide conditions which
perpetuate the use of violence (Khawaja and Barazi 2005;
Michalski 2004).
While we have attempted to follow a rigorous protocol
in the conduct of this review, it is still subject to a number
of limitations. It may be prone to indexing bias, publication
bias and reporting bias. Our ability to assess quality of the
studies that we identified was limited by the methodological
information provided in the published articles, some of
which was incomplete.
Conclusion
The high prevalence rates of violence experienced by
women suggests that doctors practicing in all areas of
medicine need to recognize and explore the potential
relevance of violence issues when considering women’s
reasons for presenting with ill health. Sensitization to the
problem of domestic violence should be incorporated not
only in medical training, but into govermental, legal, and
judicial organizations. Inconsistences in methodology identified
in the study emphasize the importance of developing
clearer definitions so that findings can be compared across
settings, to allow more accurate comparasions of prevalence
rates over time, and between different population groups.
Future research should seek to recognize cultural differences
in family functioning without necessarily viewing such
differences as ‘deviant’ or ‘pathological’, and should recog-
Garcia-Moreno C et al Bangladish 2006
Garcia-Moreno C et al Brazil 2006
Garcia-Moreno C et al Ethiopia 2006
Garcia-Moreno C et al Japan 2006
Garcia-Moreno C et al Namibia 2006
Garcia-Moreno C et al Peru 2006
Garcia-Moreno C et al Samoa 2006
Garcia-Moreno C et al Serbia 2006
Garcia-Moreno C et al Thailand 2006
Garcia-Moreno C et al Tanzania 2006
Hicks MHR et al 2006
Yang MS et al 2006
McCloskey LA et al 2005
Romito P et al 2005
Serquina-Ramiro L 2004
Salena H 2004
Eisikovits Z et al 2004
Ghazizadeh A 2005
op-Sidibe N et al 2006
Jain D et al 2004
Naved R.T et al 2006
Khawaja.M & Barazi.R 2005
Ramiro.L.S et al 2004 (Egypt)
Ramiro.L.S et al 2004 (Philippine)
Ramiro.L.S et al 2004 (Chile)
Ramiro.L.S et al 2004 (India)
Jewkes.R et al 2002
Raj A & Silverman.J.G 2002
Jewkes.R et al 2001/a
Jewkes.R et al 2001/b
Jewkes.R et al 2001/c
Ellsberg.M.C et al 1999
Deyessa.N et al 1998
CDC, Georgia 1998
Hakimi et al 2001
study_id 19.00 (17.08, 20.92)
8.30 (6.72, 9.88)
29.00 (27.38, 30.62)
3.10 (2.18, 4.02)
15.90 (14.05, 17.75)
16.90 (14.95, 18.85)
17.90 (16.04, 19.76)
3.20 (2.30, 4.10)
7.90 (6.55, 9.25)
14.80 (13.17, 16.43)
3.00 (0.51, 5.49)
10.10 (7.93, 12.27)
16.20 (14.30, 18.10)
19.00 (15.27, 22.73)
29.00 (26.19, 31.81)
70.00 (64.89, 75.11)
6.00 (4.78, 7.22)
15.00 (12.80, 17.20)
47.00 (45.79, 48.21)
24.00 (20.26, 27.74)
19.00 (17.52, 20.48)
17.40 (12.81, 21.99)
10.50 (8.11, 12.89)
6.20 (4.71, 7.69)
3.60 (1.82, 5.38)
25.30 (22.12, 28.48)
9.50 (7.91, 11.09)
26.60 (19.75, 33.45)
10.90 (7.83, 13.97)
11.90 (8.80, 15.00)
4.50 (2.61, 6.39)
27.00 (23.06, 30.94)
10.00 (7.73, 12.27)
6.00 (5.17, 6.83)
2.00 (1.01, 2.99)
ES (95% CI)
0 102030405060708090100
Fig. 5 Forest plot of prevalences
of current physical violence
from population studies
J Fam Viol (2010) 25:369–382 375
nize the complex nature of differences between and within
ethnic groups. More concentrated and culturally sensitive
research can lead to a clearer understanding of the scope and
causes of violence against women, which in turn may lead to
more effective preventive and intervention efforts.
What is already known on this topic:
• Domestic violence is increasingly recognized as a global health issue.
• In the past decade a number of prevalence surveys on intimate
partner violence have been performed.
• Widely different estimates of the prevalence of domestic violence
have been reported in different settings, suggesting a need to
standardize the methodology used in such research.
What this study adds:
• Violence against women has reached epidemic proportions in most
societies.
• This review identified major differences in methodology,
instruments, sample size, period covered, the population surveyed
and types and forms of violence studied.
• In all types of violence our meta-analysis indicated significant
heterogeneity between studies, even in studies employing standardized
methods.
• To accurately estimate the prevalence of violence in different
settings, researchers need to develop clear and consistent definitions
to allow comparisons between settings.
• prevalence of lifetime domestic violence varies from 1.9% in
Washington, US, to 70% in Hispanic Latinas in Southeast US.
Acknowledgements We would like to acknowledge the advice
given by Dr. Kalwant Sidhu, Director of the MSc Programme at
King’s College London, Martin Hewitt, who provided advice on
literature searching, Dr. Paul Seed, who provided statistical advice,
Prof. Gene Feder and Prof. Tony Ades for commenting on the paper
before submission for publication and to Jeremy Nagle in the British
Library, who helped to track down references.
Contributorship Samia Alhabib had the original idea for the study
which was refined by Roger Jones. Data collection, critical appraisal of
studies and general data analysis were undertaken by Samia Alhabib.
Meta-analysis and sensitivity analysis were undertaken by Ula Nur.
Samia Alhabib and Roger Jones drafted and finalized the manuscript.
Potential Conflict of Interest None declared.
Ethics Approval Not required.
Funding None
Kocacik F et al 2006
Garcia-Moreno C et al Bangladish 2006
Garcia-Moreno C et al Brazil 2006
Garcia-Moreno C et al Ethiopia 2006
Garcia-Moreno C et al Japan 2006
Garcia-Moreno C et al Namibia 2006
Garcia-Moreno C et al Peru 2006
Garcia-Moreno C et al Samoa 2006
Garcia-Moreno C et al Serbia 2006
Garcia-Moreno C et al Thailand 2006
Garcia-Moreno C et al Tanzania 2006
Xu X 2005
Sethi D 2004
Ruiz-Perez I 2006
Michelle Hynes et al 2004
XU X et al 2001
Fanslow.J and Robinson.E 2004
Hakimi et al 2001
study_id
38.25 (34.31, 42.20)
39.68 (37.28, 42.07)
27.13 (24.59, 29.68)
48.67 (46.89, 50.46)
12.84 (11.07, 14.61)
30.60 (28.27, 32.93)
48.59 (45.98, 51.19)
40.49 (38.11, 42.86)
22.80 (20.65, 24.96)
22.92 (20.81, 25.02)
32.86 (30.70, 35.02)
42.95 (39.02, 46.88)
34.85 (28.21, 41.49)
22.75 (18.64, 26.86)
24.91 (19.93, 29.90)
38.00 (34.12, 41.88)
16.98 (15.03, 18.94)
10.98 (8.76, 13.20)
ES (95% CI)
0 10 20 30 40 50 60 70 80 90100
Fig. 6 Forest plot of high
quality studies on life time
prevalence of physical
violence
376 J Fam Viol (2010) 25:369–382
Study ID Population % & Violence type sampling Sample size Response Case definition instrument CI ?Bias Score
Hakim et al. 2001, population study Indonesia (Java) P (LT: 11%, C: 2%), S (LT: 22%, C:
13%), E (LT: 34%, C: 16%)
? 765 94% Yes WHO interview Yes Yes 7
Hynes et al. 2004, population study East Timor Current, P; 24.8% (19.9–29.8), E;
30.5% (22.2–38.8), S; 15.7% (8.6–
22.8)
Random 288 74% Yes WHO interview Yes Yes 7
Haj-Yahia et al. 2000, population
study
Palestine Annual incidence; E; 52%,P; 52%,
S; 37.6%, EC; 45%
Random 2,800, 1,500 86.7%, 88.9% Yes CTS & ISA, Self-administered No No 6
Nikki et al. 2000, community clinic Latin Current overall prevalence; 19% Non-random 1,001 ? Yes ?AAS, interview No No 4
Naved et al. 2006, population study Bangladesh LT prevalence P; 39.7% (Urban),
41.7% (Rural), current P; 19%
(Urban), 15.8% (Rural),
Random 2,702 96% Yes CTS, interview No Yes 7
Mousavi et al. 2005, population
study
Iran LT overall; 36.8%, Incidence;
29.3%, P; 27.2%, E; 32.4%
Random 386 87.5% No Others, interview No Yes 5
Fawole et al. 2005, population study Nigeria P; Current 31.3% Random 431 ? No Others, self-administered No Yes 4
Khawaja and Barazi 2005,
population study
Jordan LT P; 42.5%, C; 17.4% Random 262 (women) 95% Yes Others, interview No No 4
Seedat et al. 2005, population study U.S LT P; 16% Random 637 71% No Others, telephone interview No Yes 5
Amar and Gennaro 2005, college
students
U.S P; C; 48% Non-random 863 ? Yes AAS, self-reported No No 4
Koziol-McLain et al. 2004, ED New Zealand P; C; 21.3%, LT; 44.3% Random 174 60% Yes interview Yes Yes 6
Fanslow and Robinson 2004,
population study
New Zealand LT P, (Auckland); 15%, 17% (North
Waikato) S: 9% in Auckland, 12%
in North Waikato.
Random 2,855 66.9% Yes WHO interview Yes Yes 8
Ramiro et al. 2004, population study Egypt, India, Philippine, Chile LT; (P): (Egypt); 11.1%, India=
34.6%, Philippines = 21.2%,
Chile= 24.9%
Random 422 (Chile), 631
(Egypt), L; 506, T;
700, V; 716, 1,000
(Philippines),
Brazil=813
96.1%(Chile),
93.5%(Egypt),
88%(India),
100%
(Philippine)
Yes Developed by researchers using
focus group, interview
Yes Yes 7
C; (P): Chile= 3.6%, Egypt=10.5%,
India=25.3%, Philippines= 6.2%
LT; E; Chile= 50.7%, Egypt=
10.5%, India=24.9%,
Philippines=19.3%.
C; E; Chile=15.2%, Egypt=10.8%,
India=16.2%, Philippines=4.8%
Swahnberg K et al. 2004, Gyn. clinic Sweden LT E; 16.8, P; 32.1%, S; 15.9%, non-random 2,439 81% Yes NorAQ No Yes 6
Koenig et al. 2004, population study Uganda LT coercive sex; 24% ? 4,279 93% Yes Interview, other methods No Yes 5
? Swahnberg I M et al. 2003,
population study
Sweden, validation study of
NorAQ
LT P; 36.4%, S; 16.9%, E; 21.4% random 1,168 61% Yes NorAQ Yes Yes 7
Grande et al. 2003, population study South Australia LT P; 16%, E; 19% random women=2,884 73.1% Yes Others, telephone survey Yes Yes 8
Harwell et al. 2003, population study American Indian C P; 5%, E; 18%, LT for both; 12% random women=588 94% Yes Others, telephone survey No Yes 6
Murty et al. 2003, population study Iowa C P; 2.9%, E; 46.7% random 689 67.1% Yes CTS, interview No Yes 7
? Bensley et al. 2003, population
study
Washington C P; 1.9%, E; 5.1% random 3,527 57% Yes BRFSS Yes Yes 7
Maziak and Asfar 2003, primary
care.
Syria C P; 23% random 411 97% Yes Others, interview No Yes 6
El-Bassel et al. 2003, ED New York, American Latin C P, 15%, S; 6%, LT P; 43%, S;
20%
Non-random 143 Not reported No Others, interview No No 1
Llika et al. 2002, primary care center Nigeria C overall; 40%, P; 15.8%, E; 20.1% random 300 100% Yes Others, interview No No 5
Okemgbo et al. 2002, population
study
Nigeria LT P; 78.7, %, S; 21.3%, Mutilation;
52.7%
Random 308 Not reported Yes Others, interview No No 4
Basile 2002, population study U.S LT S; 34% Random 602 50% Yes Others, telephone survey No No 4
? Coker et al. 2002, population study U.S LT P; 13.3%, S; 4.3%, E; 12.1%. Random 6,790 72.1% Yes CTS, telephone survey Yes No 7
Jewkes et al. 2002, population study South Africa LT P; 24.6%, Current; 9.5% Random 1,306 90.3% Yes Others, interview Yes Yes 7
Appendix
Summary Table of the include studies:
J Fam Viol (2010) 25:369–382 377
az-Olavarrieta et al. 2002, Hospital
study
Mexico P and/or S; C; 9%, LT; 26.3%. Non-random 1,780 71.9% Yes Self-administered,, AAS No No 5
Coker et al. 2002, family practice South Carolina LT P; 41.8%, S; 21.4%, E; 12.1%. ? 1,152 73% Yes Interview, ISA- to measure the
severity of physical + AAS,
web Scale for E,
No Yes 6
Melnick et al. 2002, surgical trauma
clinic
U.S C P; 18% Not-reported 127 Not-reported Yes PVS, self-administered Yes Yes 5
Romito and Gerin 2002, ER
+Community center
Italy C P and/or S; 10.2% Non-random 510 76% Yes Others, interview No Yes 5
Raj and Silverman 2002, population
study
South Asian women in Boston C P; 26.6%, S; 15%, LTP;30.4%, S;
18.8%
Snowball? 160 Not-reported Yes CTS, self-administered No No 3
Brokaw et al. 2002, ED New Mexico LT P; 47.3% Random 421 67.1% No Others, interview No Yes 5
Krishnan et al. 2001, ED U.S LT P; 72%, S; 20%, E; 92% Non-random 87 70% No Others, interview No No 2
Grynbaum et al. 2001, primary care Israel C P; 21.7%, Incidence; 10% Non-random 133 95.7% No PVS, self-administered No No 3
Barnes et al. 2001, University
students
African American LT P; 15.6%, E; 11.7% random 179 47% Yes ISA, self-administered No No 4
Weinbaum et al. 2001, population
study
California C P; 6% random 3,408 70% Yes CTS, telephone survey Yes No 7
Parkinson et al. 2001, Paediatric
clinic
Massachusetts C P; 2.5%, LT; 16.5%. Non-random 553 71.2% No Others, self-administered Yes No 4
Coid et al. 2001, primary care London LT P; 41%, S; 9% Non-random 1,207 55% Yes Others, self-administered No No 3
Subramaniam and Sivayogan 2001,
community health center
Sri Lanka LT P; 30%, C; 22% random 417 55% Yes Others, interview No Yes 5
Jewkes et al. 2001, population study South Africa 1) Eastern Cape (n=396): LT P;
26.8%, C P; 10.9%, LT S; 4.5%,
C E; 51.4%.
random 1,306 90.3% Yes Others, interview Yes Yes 7
2) Mpumalanga: (n=419), LT P;
28.4%, C; 11.9%, LT S; 7.2%, C
E; 50%.
3) Northern Province: (n=464); LT
P; 19.1%, C; 4.5%, C E; 39.6%
Plichta and Falik 2001, population
study
U.S LT P; 19.1%, S; 20.4% ? 1,821 ? Yes CTS Yes No 5
Bauer et al. 2000, primary care California 1) C P; 10%, S;3%, E; 10%, random 734 74% Yes AAS, telephone survey No No 6
2) LT P; 45%, S; 17%, E; 34%
Harwell and Spence 2000,
population study
Montana C P; 3% random 1,017 90% Yes Others, telephone interview Yes Yes 7
Coker et al. 2000, population study south Carolina LT P; 10.6%, S; 7.8%, E; 7.4% random women=314 69.4% Yes ASS, telephone survey Yes Yes 8
Caetano et al. 2000, population
study
U.S couples C P black; 23%, Hispanic; 17%,
whites; 12%
random White=555,
Black=358,
Hispanic=527
85% Yes CTS, interview No No 6
? CDC 2000, population study. South Carolina LT P; 10.6%, E; 7.4%, S; 7.8% random 313 women 69.4% Yes AAS, telephone survey Yes No 7
? CDC 2000, population study. Washington LT P; 23.6% random 2,012 women 61.4% Yes CTS, telephone survey Yes No 6
Coker et al. 2000, family practice South Carolina LT P; 40%, E; 13.6%, C P; 8.9%, E;
7.5%
Non-random 1,152 73% Yes Interview, ISA to measure
current abuse, WEB to assess
battering, AAS to measure
life-time abuse
No Yes 6
Coker et al. 2000, family practice Columbia LT P; 32%, S;17.3%, E; 12.5%, C P;
18.9%, S; 14.4%,
? 1,401 89% Yes Interview, ISA; for current S
&P, WEBS; for battering,
ASS; for life-time
No No 5
Ernst et al. 2000, ED U.S C P; 5%, LT; 38.6% ? Random 57 78% Yes Self-reported, ISA No Yes 5
Ellsberg et al. 1999, population
study
Nicaragua LT P; 40%, C; 27% ? 488 100% Yes CTS, Interview Yes Yes 7
Tollestrup et al. 1999, population
study
Mexico C P; 6.7%, E; 13.5 Random 2,415 75 Yes CTS, telephone survey No Yes 7
Deyessa et al. 1998, population
study
Ethiopia LT P; 45% (n=303), C; 10% Random 673 ? Yes Others, interview No Yes 5
Kershner et al. 1998, community
clinic
Minnesota LT P; 37%, C P; 6.6%, E; 21.1%, S;
2.1%,
Non-random 1,693 82.4% Yes Others, self-administered No Yes 5
? CDC 1998, population study Georgia C P; 6%, LT; 30% Random 3,130 78% Yes Others, telephone survey Yes No 6
Pakieser et al. 1998, ED Texas LT P; 37%, C; 10%. Non-random 4,448 40% Yes Others, self-administered No No No
378 J Fam Viol (2010) 25:369–382
Sachs et al., ED California LT P; 14.7%, C; 3.9% Non-random 480 women 66.2% Yes Others, self-administered Yes No 5
Magdol et al. 1997, population study New Zealand C P; 27.1%, E; 83.8%
Schei et al. 2006, population study Australia LT P/E/S; 27.5% Random 356 90% Yes CTS, interview No No 6
Yuan et al. 2006, population study Native American LT P;45%,S; 14% Random 793 98% Yes Others, interview No No 5
Avdibegovic et al. 2006, psychiatric
clinic
Bosnia and Herzegovina LT,P; 75.9%, P & S; 43.5%, E;
85.6%
Random 283 89.5% Not reported DVI, interview No No 4
Kocacik et al. 2006, population
study
Turkey LTE; 53.8%, P 38.3%, S;7.9% random 583 100% Not reported WHO, interview No No 5
WHO, Garcia-Moreno et al. 2006,
population study
Bangladesh, Brazil, Ethiopia,
Japan, Namibia, Peru, Samoa
(National), Serbia, Thailand,
Tanzania,
Bangladesh: LT (P:39.7%,
S:37.4%), C (P19%,S:20.2%)
random 24,097 Japan (60.2%),
other countries
range; 85–
97.8%
Yes Interview, built on CTS Yes Yes 8, in
Japan=7
2-Brazil: LT (P27.2%,S 10.2%), C
(P8.3%,S 2.8%).
3. Ethiopia: LT (P48.7%, S 58.6%),
C (P29%, S 44.4%).
4. Japan; LT (P12.9%, S 6.2%), C
(P3.1%, S 1.3%).
5. Namibia: LT (P30.6%,S 16.5%),
C(P15.9%,S9.1%).
6. Peru: LT (P48.6%,S 22.5%), C
(P16.9%, S 7.1% ).
7. Samoa: LT (P40.5%, S 19.5%),
C (P17.9%, S 11.5%).
8. Serbia: LT (P22.8%, S 6.3%), C
(P3.2%, S 1.1%).
9. Thailand: LT (P22.9%, S
29.9%), C(P7.9%, S 17.1%).
10. Tanzania: LT (P32.9%, S 23%),
C (P14.8%, S 12.8%).
Hicks et al. 2006, population study Chinese American LT P;13%, C; 3%, random 323 56% Yes CTS, interview Yes Yes 7
Yang et al. 2006, population study Taiwanese aboriginal tribes LT prevalence P; 15%, C; 10.1%, S:
4%
random 876 84.7% No ASS, interview Yes No 6
Thompson et al. 2006, population
study
Washington LT prevalence (P; 44%, S: 30.3%,
E: 35.1%)
random 3,568 56.4% Yes WEB, telephone survey No No 5
Ruiz-Perez et al. 2006, general
practice
Spain LT prevalence; P: 14.3%, E: 30.8%,
S: 8.9%
Random 1,402 88.35% Yes WHO, self-administrated No No 6
Ergin et al. 2005, primary care Turkey (Bursa) LT P; 34.1%, E; 15.8%, economic;
8.2%, all-type violence; 29.5%
Not reported 1,427 71% Yes AAS, interview No Yes 6
McCloskey et al. 2005, population
study
Mohsi (Tanzania sub-Saharan
Africa)
LT P: 19.7%, S: 3.4%, C: P; 16.2%,
S: 1.4%.
Random 1,444 71% Yes One item from CTS, and 2
items from AAS, one item
from SES, interview
Yes No 7
Overall prevalence: 26%
Bengtsson-Tops 2005, psychiatric
clinic
Sweden LT P; 28%, S; 19%, Economic;
16%; E; 46%.
Non-Random 1,382 79% Yes Others, interview No No 4
C; P; 6%, S;3%, Economic; 6%, E;
22%
Kyu and Kana 2005, population
study
Myanmar (South-East Asia), C; P; 27%, E; 69% Random 286 82% Yes CTS, self-administered No No 5
Burazeri et al. 2005, population
study
Albania C; P; 37% Random 1,196 87% No Others, interview Yes No 5
Mayda and Akkus 2004, population
study
Turkey LT P; 41.4%, E; 25.98%, S; 8.6%,
E; 77.6%
Non-Random 116 100% Yes Others, interview No Yes 4
McFarlane et al. 2005, primary care U.S C P&S; 8.9% in White, 6% in
African American, 5.3% in
Hispanic.
Non random 7,443 Not reported Yes Others? No No 4
Romito et al. 2005, family practice Italy Overall P, S, E, LT: 27.4%, C:
19.9%
Non random 444 78.6% Yes Others, self-administered No No 4
Newman et al. 2005, paediatric ED Chicago C P & S; 11% Non random 461 Not reported Not reported AAS, self-administered No No 3
Hegarty and Bush 2002, general
practice
Australia LT, P: 23.3%, E: 33.9%, S; 10.6% random 2,338 78.5% Yes AAS, self-administered Yes No 6
J Fam Viol (2010) 25:369–382 379
Dal Grande et al. 2003, population
study
Australia LT P; 16%, E; 19%. random 6,004 73.1% Yes Others, telephone interview Yes Yes 7
Xu X et al. 2005, gynecology clinic China (Fuzhou) Overall LT P, S, E; 43%, C; 26% random 685 89% Yes WHO Q, interview Yes No 7
Parish et al. 2004, population study China LT P; 34% random 1,665 women 76% No Others, interview No No 4
John et al. 2004, gynecology clinic North England LT P; 21%, C: 4% Non random 920 90% Yes AAS, self-administered No No 5
Romito et al. 2004, primary care Italy LT P; 14.1%, S; 17.6%, E; 16.4% Non random 542 8.6% Yes Others, Self-administered Yes No 5
C: P; 5.2%, S: 5.2%, E: 19%
Serquina-Ramiro et al. 2004,
population study
Manila LT P; 47.2%, C; 29% Random 1,000 90% Yes WorldSAFE, interview No Yes 7
Rivera- Rivera et al. 2004,
population study
Mexico LT P; 35.8% random 1,641 93.5% Yes CTS, interview Yes Yes 8
Keeling and Birch 2004, Hospital Warral, UK LT ?P: 34.9%, C; 14% Non random 294 99.3% No AAS, self administered Yes No 4
Cox et al. 2004, ED Northern Canada Overall life-time P & E: 51%, C:
26%,
random 1,223 80% Yes Others, interview Yes Yes 8
Incidence: 18%
Kramer et al. 2004, primary care U.S LT: P; 49.5%, S; 265, E; 72%. Non random 1,268 9% in each cell Yes AAS, self administered Yes No 6
C; P; 11.7%, S; 4.2%, E; 27.9%.
Sethi et al. 2004, ER UK Life-time P.; 34.8%, C; 6.1% Non random 228 86.8% Yes WHO Q, interview Yes No 5
Peralta and Fleming 2003, family
medicine
Madison, Wisconsin C; P: 10.3%, E; 43.5% Non random 399 Not reported Yes CTS, self reported No No 4
Ruiz-Perez et al. 2006, primary care Spain LT of any violence; 22.8% Non random 449 89.08% Yes WHO Q, self administered No No 5
Lown et al. 2006, population study California C P; 27.4%, S; 6.7% Non random 1,786 85% Yes CTS, interview Yes Yes 7
Ghazizadeh et al. 2005, population
study
Iran LT P; 38%, C; 15% random 1,040 97% No Others, interview No No
Faramarzi et al. 2005, obstetric/
gynecology clinic
Iran C P; 15%, S; 42.4%, E; 81.5% Non random 2,400 Not clear Yes AAS, interview No No 5
Ahmed and Elmradi 2005, medical
center
Sudan C P & E; 41.6% Non random 492 86.8% Yes Others, self-administered No No 4
Evans-Campbell et al. 2006,
population study
New York LT P; 40% random 112 women 83% No Others, interview No Yes 4
op-Sidibe et al. 2006, population
study
Egypt LT P; 34.3%, C; 47% random 6,566 99% Yes Others, interview No No 5
Apler et al. 2005, primary care Turkey LT P; 58.7%, C P; 41.1%%, E;
33.6%
Non random 506 Not reported Yes AAS, interview No No 4
Coid et al. 2003, general practice Hackney, east London LT S; 24% Non random 1,206 54% Yes Others, self administered Yes No 4
Siegel et al. 2003, pediatric setting U.S Incidence; 6%, LT P; 22%, C: 16% Non random 435 Not reported No Others, self administered No Yes 3
Boyle and Todd 2003, ED Cambridge LT P; 21.3%, C; 6.1%, incidence:
1.2%
random 307 84.8% Yes Others, interview Yes No 5
Shaikh et al. 2003, obstetric/
gynecology clinic
Pakistan LT P; 55.9%, E; 75.9%, S; 46.9% Non random 307 70.4% Yes Others, interview No No 3
Richardson et al. 2002, general
practice
East London LT P:;41%, C; 17%, E; 74% Non random 2,192 64% Yes Others, self administered Yes Yes 6
Bradley et al. 2002, general practice Ireland LT P; 39%, E; 54% Non random 2,615 72% Yes Others, self administered Yes No 5
Mazza et al. 2001, population study Australia Overall LT prevalence; 28.5%, E;
17%, S; 40.8%,
Non random 395 90% Yes CTS, self-administered Yes No 6
Zachary et al. 2001, ED New York C P; 7.9%, LT; 38% Non random 795 76.8% Yes CTS, interview No Yes 6
Az- Olavarrieta et al. 2001, hospital
study
Mexico LT P; 14%, E; overall; 40%, S; 9.3% Non random 1,255 83% Yes Others, elf-administered Yes No 5
Augenbraun et al. 2001, hospital
study
Brooklyn, NY LT P; 37.6%, E; 32.8%, C P;
15.5%, E; 19.1%
Non random 375 96% Yes Others, elf-administered No Yes 5
Lown and Vega 2001, population
study
Fresno County, California C P; 10.7% Random 1,155 90% Yes AAS, self-administered Yes Yes 8
Hedin et al. 2000, gynecology clinic Sweden C; P; 6%, S; 3%, E; 12.5% Non random 207 64% Yes SVAW, self-administered No No 3
Jones et al. 1999, HMO survey Washington DC LT P, S, E; 36.9%, C; 4% Non random 10, 599 14% Yes AAS, self-administered No No 4
Duffy et al. 1999, pediatric ED New England city LT P; 52%, S; 21%, Non random 157 Not reported Yes AAS, interview No Yes 4
Fikree and Bhatti 1999, primary care Pakistan, Karachi LT P; 34% Non random 150 Not reported No Others, interview No No 1
Dearwater et al. 1998, ED Pennsylvania & California LT P/E; 36.9%, C P/S; 14.4% Non random 4,641 74% Yes AAS, self-administered Yes Yes 7
Ernst et al. 1997, ED New Orleans LT non P; 22%, P; 33%, C non-Pl;
15%, current P; 19%
random 283 women 94% Yes ISA, self-administered No No 5
380 J Fam Viol (2010) 25:369–382
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APA Module Assignment
For this assignment, you will review materials in the DeVry library to help gain a better understanding of APA citations.
a.    Click https://hub2.devry.edu/node/272
b.    Listen to the tutorial or download and review the transcript on APA and answer the questions below
After reviewing the presentation, compose a 2-paragraph response in which you address each of the following points:
1.    Why is APA style used to document ideas in writing? What is the purpose of the in-text citation? Demonstrate your understanding of the in-text citation by providing an in-text citation for the article you summarized for the week 2 assignments. (15 points)
2.    In the article that you summarized in week 2, you may have found some information that you want to quote directly. To demonstrate the process for citing a direct quote, provide an example of properly quoted material. (20 points)