Perceptions and experiences of women about their help seeking behavior violence for domestic violence in Chitral : a qualitative exploratory case study design

Date of Award


Document Type


Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)


Community Health Sciences


Domestic violence against women (DV) is a widely prevalent public health issue that affects all social classes but most significantly low socioeconomic strata in the world. According to WHO 2013 report, the prevalence of DV is 30% in the world, 37.7% in South East Asia and 30-35% in Pakistan. Electronic media reported 67% prevalence of DV against women in the remote district of Chitral, Pakistan [24]. Help seeking in DV have important relations with effective handling; and eradicating the issue because it enhances women autonomy, increase her access to support services and visibility of the issue to grasp the attentions of relevant community and organization stakeholders. Although the issue has been studied in different other countries but we have scarcity of relevant researches in Pakistan. This qualitative case study was designed with the aim to reveal women's perceptions and experience of barriers and facilitators for help-seeking in different forms of DV with regards to sociocultural characteristic of rural women and perpetrators. Moreover, the study also intends to add a valuable insight about the effectiveness of the existing services for DV sufferers in the district to develop women focused interventions and policies. Research question: What are perceptions and experiences of women about their help seeking behavior for domestic violence in Chitral? Methodology: Qualitative exploratory case study design was used taking context of Chitral, DV survivors as a case and formal and informal help seeking as unit of analysis. The participants were reproductive aged (18-55 years) ever married Chitrali women who have suffered DV in some point in their life. Through purposive sampling the formal help seeker women were selected from data registry of the legal and humanitarian institutions (AKHSP, District bar court and LAPH) where they have sought help and were interviewed in the same setting. The non-help seekers were identified through social networks of family, friends or informal social organizations by using snow ball sampling and interviewed in AKHSP health centers of Brep and Chuinj. Qualitative information about the perceptions and experiences of women about their help seeking behaviors were collected through open ended in depth interviews via a semi-structured interview guide from July to August 2017. Key informants (KIs) from relevant organizations (healthcare, district Bar, and human right) were interviewed to better understand their accessibility and service provision dynamics to DV affected women. Privacy of the participants was ensured during interview and confidentiality of the data is guaranteed through cumulative presentations of the findings and using codes or pseudonyms. Data was analyzed through thematic and content analysis by manual coding and through Nvivo software. Results: Our study found married women in Chitral suffer various form of domestic violence and perpetrators are husband and in-laws. The contextual dynamics are influence of joint family, normalcy of DV after marriage, transmission of social norms, gender inequalities, drug addiction and lack of awareness about woman right. DV help seeking among women is proportionately very less due to different sociocultural and organizations factors. Stigmatization, female powerlessness,dependency on others, fear of worsening the situation, fear of losing children custody and safeguarding family honor (in-laws and parents) and hassles of formal procedures found to be barriers for survivor's help seeking. Parental family found to be most trusted, accessible and frequently sought informal support system for DV survivors followed by community based organizations like Jirga and arbitration board. Survivors often approach AKHSP healthcare facilities for curative reasons without disclosing the actual issue of DV, formal justice systems (court and LAPH) are considered last option if the survivor wants a complete escape from the abusive relationship or there is some urgent that women face. Conclusion: This was the first study of its kind in the context of Chitral to explore unexamined issue of DV against women and associated help seeking by survivors. Based on the findings of the study we recommend the relevant organizations to integrate DV screening, management and referral facilities in the existing structure of their service provision. The study has implication for humanitarian and legal organizations to enhance their screening skills, visibility, and access, create awareness and empower women of the district so they could approach someone for support instead of silently suffering and ending their life due to misery of DV. The study has implications for the local administrators and policy personal to strengthen service provision by effective implementation of the existing women protection policies in the district.

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