Pathways Between Neighbourhood Norms And Intimate Partner Violence: A National Survey Among Ugandan Women

Evidence suggests that gendered social norms play a significant role in the increased prevalence of intimate partner violence (IPV) at both individual and household levels. While some relationships may exhibit abusive dynamics from the beginning, IPV frequently starts with subtle non-physical behaviours, such as threats, control, rejection and gaslighting among others before escalating into more severe forms of abuse over time. We use the DHS 2016 survey data from Uganda to examine whether emotional abuse by a woman's partner mediates the association between norms regarding wife beating and instances of self-reported physical or sexual IPV, analysed through structural equation modelling. We also explore the impact of alcohol consumption by the victim's partner. Results: The prevalence of emotional abuse, physical and sexual IPV in the 12 months preceding the survey was 29.3%, 21.9% and 16.4% respectively. The majority (65.6%) of those who reported physical or sexual IPV also reported experiencing emotional abuse. Women residing in neighbourhoods with higher scores on norms indicating greater acceptance towards wife beating had higher odds of experiencing physical (OR = 5.94; 95% CI [2.99, 11.79]) or sexual IPV (2.71; [1.36, 5.39]) compared to neighbourhoods with lower scores. Mediation analysis showed that emotional abuse mediated the association; there was a direct positive association between neighbourhood norms and physical IPV (4.82; [2.15, 10.79]) but weak evidence for sexual IPV (1.87; [0.95, 3.68]). The estimates remained largely unchanged in the presence of alcohol use. Independently, neighbourhood norms associated with physical IPV (2.48; [1.28, 4.83]) and sexual IPV (2.27; [1.21, 4.28]). Emotional abuse as a precursor to physical and sexual abuse could have implications for IPV programming and interventions. In addition to efforts that target changing negative social norms, interventions might benefit from strategies to easily identify emotional abuse.