In 1998 a cross-sectional study of violence against women was undertaken in three provinces of South Africa. The objectives were to measure the prevalence of physical, sexual and emotional abuse of women, to identify risk factors and associated health problems and health service use. A multi-stage sampling design was used with clusters sampled with probability proportional to number of households and households were randomly selected from within clusters. One randomly selected woman aged 18–49 years was interviewed in each selected home. Interviews were held with a total 1306 women, the response rate was 90.3% of eligible women. For the risk factor analysis, multiple logistic regression models were fitted from a large pool of candidate explanatory variables, while allowing for sampling design and interviewer effects. The lifetime prevalence of experiencing physical violence from a current or ex-husband or boyfriend was 24.6%, and 9.5% had been assaulted in the previous year. Domestic violence was significantly positively associated with violence in her childhood, her having no further education, liberal ideas on women's roles, drinking alcohol, having another partner in the year, having a confidant(e), his boy child preference, conflict over his drinking, either partner financially supporting the home, frequent conflict generally, and living outside the Northern Province. No significant associations were found with partners’ ages, employment, migrant status, financial disparity, cohabitation, household possessions, urbanisation, marital status, crowding, communication, his having other partners, his education, her attitudes towards violence or her perceptions of cultural norms on women's role. The findings suggest that domestic violence is most strongly related to the status of women in a society and to the normative use of violence in conflict situations or as part of the exercise of power. We conclude by discussing implications for developing theory on causal factors in domestic violence.
Intimate partner violence, or domestic violence, is increasingly being recognised as a public health problem and associated with injuries and a wide range of other mental and physical health problems (Campbell et al., forthcoming; Heise, Ellsberg, & Gottemoeller, 1999). Its causes have preoccupied social scientists for several decades. Hypotheses that domestic violence might be biologically determined were significantly undermined by observations that its occurrence varies considerably between as well as within societies, and in some it has been reported to be exceptionally rare or even absent (Levinson, 1989; Counts, Brown, & Campbell, 1992). Understanding of social causation has been significantly hampered by the narrow geographical base of research (most work being from North America), a tendency of academics and activists to pursue single-factor theories and the reliance on data from small samples or women who had succeeded in accessing sources of help such as shelters (Hoffman, Demo, & Edwards, 1994; Heise, 1998). In the last decade there have been several papers from well-designed studies conducted in a range of countries which discuss risk factors and processes using survey (e.g. Hoffman et al., 1994; Ellsberg, Pena, Herreras, Liljestrand, & Winkvist, 1999; Martin, Tsui, Maitra, & Marinshaw, 1999; INCLEN, 2000) and ethnographic methods (e.g. Rao, 1997; Wood & Jewkes, 2001; Bourgois, 1996; Harvey & Gow, 1994). These have enabled hypotheses to be explored more critically and an understanding of the social plausibility of relationships. However the body of evidence available to date falls very far from the standards of epidemiologists for establishing disease causation (Hill, 1965).
