more than one answer)
a.
b.
c.
d.
e.
f.
g.
h.
Economic reasons
Drugs
Patriarchal beliefs
Lack of Education
Housing issues
Other……………………………………
RF
DK/NA
Prevalence
87.
Have you ever experienced any form of
domestic violence?
a.
b.
c.
d.
88.
Yes
No [Skip to Qu 89]
RF [Skip to Qu 89]
DK/NA [Skip to Qu 89]
Has anyone close to you (your relative/
close friend) experienced any form of domestic violence?
a.
b.
c.
d.
Yes (if yes i,ii,iii)
No
RF
DK/NA
(if yes to question 86 and 87, please ask the follow‐
ing 3 questions)
(i) What type(s) of abuse was it?
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
o.
82
Physical abuse
Verbal abuse / psychological abuse
Sexual abuse
Economic / Financial abuse
Impregnating the spouse, without concern to her health condition and against
any medical advice to refrain from impregnation for a specified period of time
Impregnating a women, who is trying to
remove herself from a harmful marriage,
against her will;
Deliberately withholding the property of
a person;
intimidation;
harassment;
stalking;
damage to property;
entry into, and being present thereafter
at the victim’s residence without consent,
where the parties do not share the same
residence;
any other act which may be described as
controlling or abusive behavior towards
the victim;
coercing, intimidating or forcing the victim to commit an act which such person
would not have consented to or committed by their own volition;
confining the victim to a place or restricting their movement against their will;
p. attempting to commit any of the foregoing acts or causing apprehension of such
acts; or
q. Causing a minor to witness or hear an
act of domestic violence or presenting or
placing a minor in such situation where
such minor may witness or hear an act of
domestic violence.
r. Other…………………………………
s. RF
t. DK/NA
(ii) From whom?
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
Husband / Wife
Father
Mother
Exhusband / Exwife
Boyfriend / Girlfriend
Exboyfriend / Exgirlfriend
Relative
Inlaws
RF
DK/NA
(iii) When did the act(s) of violence happen?
a.
b.
c.
d.
e.
f.
In the past 12 months
In the past 1-5 years
In the past 5-10years
10 years ago
RF
DK/NA