History of domestic violence among women and incidence of stunting in rural areas in Bali Province, Indonesia

doi:10.21203/rs.3.rs-4679200/v1

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History of domestic violence among women and incidence of stunting in rural areas in Bali Province, Indonesia

https://doi.org/10.21203/rs.3.rs-4679200/v1

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Background

Sustainable Development Goals (SDGs) numbers 2 and 5 aim to end all forms of malnutrition and achieve gender equality, including meeting internationally agreed targets by 2025.

Objective

This study aims to determine the incidence of stunting in children under five years of age raised by mothers with a history of domestic violence in rural areas of Karangasem Regency, Bali Province, Indonesia.

Methods

This mixed-methods study (quantitative-qualitative) involved 133 women of childbearing age with stunted toddlers in Abang I and Kubu II subdistricts. Probability sampling was used to select participants. Data were collected through self-reported questionnaires, in-depth interviews, observations, and Focus Group Discussions (FGDs). The study was conducted from May to October 2023.

Results

Most respondents were aged between 20–35 years (66.17%) and had primary education (74.44%). A majority were unemployed (65.41%) and had low incomes (87.97%). All respondents had stunted toddlers. The highest incidence of domestic violence (DV) experienced was social abuse (44%), followed by economic abuse (37.59%), emotional abuse (28.6%), physical abuse (17.29%), and sexual abuse (8.3%). There was a significant relationship between income level, parenting patterns, and the incidence of stunting (p < 0.05).

Conclusions

The study found that stunting is prevalent among mothers who experience DV. The main theme from the thematic qualitative analysis is that women lack strong autonomy and power within the family. The recommendation is to increase women's autonomy through empowerment and entrepreneurial efforts and to screen for DV victims in basic health facilities.

Domestic violence

women of childbearing age

stunting

children under five years of age

women autonomy

One of the goals of Sustainable Development Goals (SDG's) number 2 is to end all forms of malnutrition, including achieving internationally agreed targets by 2025. Health services in Indonesia for stunting intervention generally emphasize sensitive intervention programs (70%) and specific interventions (30%) (1). Stunting prevention is specifically emphasized in the period before and after the birth of a baby and during adolescence (2–5). There have been no wider scale studies in Indonesia regarding the relationship between stunting and a history of domestic violence/DV, including women's autonomy in the family (6, 7). Midwives, as women's friends, can provide assistance effectively and efficiently in basic health services (8).

The incidence of stunting in Bali is the lowest in Indonesia, it is hoped that this figure can be reduced or even eliminated (7). The kinship pattern in Bali is generally patriarchal. Men have privilege as makers and decision makers. Women play more roles as decision makers, including in the health sector (6, 7). The results of data analysis found that as many as 1 in 4 women or 25% admitted that they had been victims of DV in the Abang I and Kubu II Health Center areas (9). The role of midwives in society still has a place in women's hearts throughout the life cycle. Midwives are women's friends, so it is hoped that midwives can study in a focused manner the experiences of women as victims of DV. Screening women for possible DV victimization requires adequate training and experience (1, 10, 11). However, screening of female DV victims in Bali is still very limited. This condition can be caused by the absence of policy priorities related to the elimination of DV (12, 13). Even though the SDGs related to gender equality and women's health have been on the agenda.

Stunting refers to a child who is too short for his or her age. Children affected by stunting can suffer severe irreversible physical and cognitive damage that accompanies stunted growth. The devastating consequences of stunting can last a lifetime and even affect the next generation (14). According to the Ministry of Health of the Republic of Indonesia, stunted or short toddlers with body length according to their age are compared with the 2006 WHO-MGRS (World Health Organization-Multicenter Growth Reference Study) standard, then the Z-score value is ≤ 2 SD (standard deviation) = stunted, and if ≤ 3 SD it is called severely stunted (15, 16). Stunting is caused by multi factorial causes, so it requires integrated efforts and strong collaboration across sectors to determine the root of the problem. The main causes of stunting include: lack of nutritional intake, disruption of growth hormones and the presence of infectious diseases (17–19), low levels of early initiation of breastfeeding, low family socioeconomic status, and mothers with a low body mass index (BMI) (20).

The incidence of stunting has continued to decline over the last decade, namely until 2022, as many as 148.1 million, or 22.3 percent of children under the age of 5 worldwide were affected. Almost all children affected by stunting live in Asia (52 percent of the global share) and Africa (43 percent of global share) (14). The surprising results of the study are that there is a link between women's position in the family or autonomy, parenting style, and a history of domestic violence and the incidence of stunting (20–25). Women with a history of experiencing domestic violence and subordination have a higher risk of having children with a malnutrition index (18, 26–28). The results of previous studies have not found a clear relationship between women's autonomy in the family and a history of experiencing domestic violence and the incidence of stunting in Indonesia.

Previous studies conducted by Rahyani et al (2021) found that pregnant women who had experienced violence by their partners/husbands tended to experience more psychosomatic complaints, suicidal thoughts and delays in getting antenatal care and miscarriages. The occurrence or history of domestic violence is related to HIV/AIDS transmission (19, 20). There are still underreported incidents of domestic violence in Bali Province in 2019–2022. In 2019, data was obtained from 155 victims who reported it to the Regional Women and Children Protection Commission (RWCPC) (29). The highest incidence was in Denpasar City. There are still many incidents that are not reported due to various considerations (29). The negative impact of DV on women's health and well-being. Acts of violence or arbitrary actions by intimate partners can cause physical trauma, psychological trauma and fear in women who become victims (6, 7). The physical trauma experienced ranges from mild to severe, resulting in disability and even death in women (30). Physical disorders or trauma affect the mental health condition of victims in the form of post-traumatic stress disorder, anxiety, depression, eating disorders and even suicidal thoughts (7, 31–37).

Until now, the stunting intervention program is more bureaucratic and specific, in the form of providing blood supplement tablets to prevent anemia, providing basic immunizations and boosters to babies and children, providing additional food at integrated service posts (Posyandu), and pregnancy checks at least six times in health facilities and examination by a specialist obstetrician (16). Studies have been conducted on the determinants of stunting in several countries. The results obtained were that there was an influence of sociodemographics and women's autonomy on the incidence of stunting (11, 14, 25, 29–37). There is an influence of a history of being a DV victim on the incidence of stunting, although the results are still controversial. There have not been any extensive studies regarding the socio-demographic influence of Balinese society regarding parenting patterns, women's autonomy in the family and the history of DV and stunting. This study aims to determine the incidence of stunting in children under five years of age raised by mothers with a history of domestic violence in rural areas of Karangasem Regency, Bali Province, Indonesia.

The study was conducted in two areas in Karangasem district, Bali Province, Indonesia. The Abang I and Kubu II areas were chosen with the consideration that these two areas have the highest stunting incidence data in Karangasem Regency. The incidence of stunting based on data from the Integrated Community Nutrition Application Measurement Input until February 2024 showed that the highest incidence of stunting was in the Abang I (10.01%) and Kubu II (8.76%) areas. Another consideration in choosing Karangasem Regency was based on research conducted on the history of DV incidents in pregnant women in the Rendang Community Health Center area. So, it can be used as a basis for further studies. The study was conducted for six months from May to October 2023. A total of 133 women of childbearing age who had stunted toddlers were involved in the study. The study design is mixed method (quantitative-qualitative). The quantitative design is in the form of an observational study through surveys on predetermined families.

Data Collection

Quantitative data was collected using a self-reported questionnaire instrument, which contains data on respondents' characteristics, history of pregnancy, childbirth, postpartum, husband and family support, including history of domestic violence experienced. Qualitative data includes focus group discussion guidelines for midwives, in-depth interview guidelines for respondents regarding the history of violent incidents they have experienced in the last 12 months. While collecting data about the history of domestic violence among respondents, researchers prepared tissue (if the respondent was sad/crying), snacks for toddlers, play equipment and drawing tools. Data collection is carried out at service points or posyandu, as well as at health facilities.Study sample and exclusions

The stunting data from the register that had been obtained was then involved in the study, namely stunting toddlers who came to the integrated service post (Posyandu) from June to September 2023. The sampling technique was total sampling that met the inclusion and exclusion criteria.

1. Inclusion criteria include: a. Complete family (husband, wife and children under two years old and/or children under five years old); b. have a book on Maternal and Child Health; c. Have visited a Posyandu (in the last 12 months); d. Complete immunization (basic); e. The child has no history of chronic disease; f. Willing to be involved in research.
2. Exclusion criteria: a. Children are cared for by other families (adopted/placed in care); b. Children with congenital disabilities; c. Not present when the research took place.

Data Analysis

Data analysis was carried out in the form of univariate and bivariate analysis. Univariate analysis with proportions, and bivariate tests using logistic regression tests, because the data scale is categorical, the data is normally distributed. Meanwhile, qualitative data analysis uses thematic analysis. Data analysis was carried out by statistical experts from Gadjah Mada University, Yogyakarta, using the STATA program. Analysis data has been saved in the link related to the research results report, namely https://drive.google.com/drive/folders/1lxwh2A5hqB4oiP14Nv3xsuHT4DcCVHvP?usp=sharing.

Ethics

Research ethics are fulfilled by complying with the applicable code of ethics, namely: respect for person, beneficence and justice.The respondents involved, before being interviewed and completing the questionnaire, were given detailed information about the research, the role of the respondents, benefits, data confidentiality, rights and stages of data collection. After the respondent gives approval, they continue by signing the informed consent. Before data collection was carried out, researchers had obtained ethical approval from the Denpasar Ministry of Health Polytechnic Research Ethics Commission, number: LB. 02.03/EA/KEPK/0659/2023.

Respondent Characteristics

The results of the analysis showed that there was no difference in the age of respondents between respondents in Kubu II and Abang I. Most respondents were aged between 20–35 years (88 people/66.17%), the highest level of education of respondents was primary education (99 people/74.44%), the highest level of husband's education was primary education (85 people/63, 91%). Most of the respondents did not have occupation (87 people/65.41%), while all husbands had occupation (133 people/100%). Most of the respondents' husbands had incomes below the minimum wage in Karangasem Regency (117 people/87.97%), a similar condition was found in the wives' incomes, almost all of which were below the Regional Minimum Wage in Karangasem Regency (131 people/98.50%). Most respondents live in mountainous areas (120 people/90.23%).

Respondents' obstetric history related to the highest number of pregnancies was multigravida (97 people/72.93%). Birth history or number of births was multiparity (100 people/75.19%). There is still a history of pregnancy and childbirth more than 4 times. The history of the type of delivery was almost the same between normal delivery and delivery by cesarean section (72 people vs 60 people/54.14% vs 45.11%).

History of being a victim of domestic violence in the last 12 months

Overall, the number of respondents who experienced physical violence was 30 people/22.56%. Incidents or history of domestic violence experienced by women/respondents in the last 1 year include physical, economic, social, sexual and psychological violence. Social violence is the form of violence most frequently experienced by respondents (64 people/48.12%), followed by economic violence (50 people/37.59%), psychological violence (38 people/28.57%), physical violence (30 people/22.56%), and sexual violence (11 people/8.27%). In the image below, a graph of incidents of domestic violence in the last 12 months is shown (Fig. 1).

Types of social violence experienced by women out of 64 people (48.12%) in the form of: husbands insulting their wives by saying they are crazy, stupid, useless (58 people/43.61%), husbands forbid their wives/women to meet their family, parents, friends (6 people/10.34%), and husbands forbid using cellphones, spying (3 people/6.9%). In the picture below, the types of social violence experienced by respondents in the last year are shown.

Figure 2. History of Types of Social Abuse

The types of economic violence experienced by women are husbands forbidding their wives from working (17 people/34%), wives handing over salaries or money to their husbands (2 people/4%), and husbands managing all finances in the family (48 people/96%).

Forms of psychological violence experienced by women are husbands insulting and degrading respondents' self-esteem (23 people/60.53%), husbands threatening and intimidating women (19 people/50%), and husbands ignoring the needs of women and their children (18 people/47, 37%).

The types of physical violence experienced by respondents/women were mainly husbands letting their wives get sick without paying attention to medical costs (23 people/76.7%), husbands often hitting, kicking and dragging their wives (12 people/40%).

The most frequent forms of sexual violence experienced by respondents were husbands forcing to have sexual relations while drunk (8 people/72.73%), and forcing them to have sexual relations using violence (4 people/36.4%).

The relationship between sociodemographic characteristics and the incidence of stunting

The results of the analysis regarding the relationship between demographic characteristics and the incidence of stunting showed that the respondent's age, geographical area, women's autonomy, and parenting autonomy were not significantly related to the incidence of stunting (p > 0.05). However, the respondent's socioeconomic or income is related to the incidence of stunting (p < 0.05). In the table below, the results of the analysis of the relationship between the sociodemographic characteristics of respondents and the incidence of stunting in the Abang I and Kubu II Community Health Center areas are displayed.

Table 1

Sociodemographic characteristics of respondents and the incidence of stunting in the Abang I and Kubu II Community Health Center
No	sociodemographic characteristics	Yes (n, %)	No (n, %)	Total (n, %)	RR	ᵡ²	95% CI	Sig
		Stunting
1.	Age (years) < 20 ≥ 20-<35 ≥ 35	5 (83.33) 85 (96.59) 38 (97.44)	1 (16.67) 3 (3.41) 1 (2.56)	6 (100.00) 88 (100.00) 39 (100.00)	0.855	2.44	0.5958–1.2276	0.118
2.	Income <Regional Minimum Wage ≥ Regional Minimum Wage	102 (98.08) 26 (89.66)	2 (1.92) 3 (10.34)	104 (100.00) 29 (100.00)	1.093	4.45	0.9639–1.2414	0.035*
3.	Geographic area: Mountain area Coastal area	115 (95.83)	5 (4.17)	120 (100.00)	0.958	0.56	0.9232 − 0.09947	0.453
4.	Parenting autonomy High Low	76 (98.70) 52 (92.86)	1 (1.30) 4 (7.14)	77 (100,00) 56 (100,00)	1.063	3.06	0.9841–1.1480	0.045*

The relationship between a history of domestic violence and the incidence of stunting

The results of the analysis showed that there was no relationship between the history of incidents of violence against women and the incidence of stunting (p > 0.05). Statistically, the results show that there is no significant relationship, but practically it appears that the incidence of stunting in the group of women who experienced violence. This is proven by the incidence of stunting being higher in the group of women who experienced physical violence, 29 people (96.67%) compared to those who did not experienced physical violence (4 people/3.88%). Similar conditions also mean that psychological/emotional violence and social violence have a higher incidence of stunting (37 people/97.37%) vs. not being victims of domestic violence (4 people/4.21%). The incidence of stunting in the group of respondents who were victims of sexual violence was 10 people (90.91%) compared to the group who did not experience domestic violence (4 people/3.28). The incidence of stunting was more frequently found in the group of respondents who were victims of economic violence (49 people/98.00%) when compared to the group who did not experience economic violence (4 people (4.82%). All respondents involved in this study had stunted children under five.

Qualitative Results

The results of the FGD related to risk factors for stunting, policy plans for managing history of domestic violence, women's autonomy and stunting in the Kubu II and Abang I health center areas, in general it was found that the risk factors for stunting in the two health centers were almost the same. The main risk factor is parenting patterns including nutritional requirements for toddlers, providing additional food and inappropriate complementary foods for breast milk. Child care by parents or in-laws who do not meet health standards. Parental knowledge is in addition to socio-economic level which triggers stunting. This was conveyed by several sources who were present during the FGD, as described below.

“In Ababi Village, perhaps because of the food and menu provided every day, for example, there are families who only provide one type of menu at home." (R2)

"In Kesimpar Village it is caused by economic factors ma'am." (Respondent 1)

"In Pidpid Village, it is more like a parenting style for children or toddlers who are looked after by their grandmother. The toddler's parents have provided food that the toddler must consume, but because the toddler is being looked after by his grandmother, when the toddler refuses the food that has been provided, the grandmother will provide substitute food so that the toddler will eat." (R3)

"The level of knowledge and economic factors as well as the high number of cases of young marriages also influence the mother's level of knowledge and influence the way the mother raises her child." (R5)

"In Tista Village, most of it is due to economic factors because the area is a hilly area and the Tista area has only just received access to clean water assistance from the Regional Drinking Water Company. There is a Tista area called Batu Madeg, of the 35 cases of stunting there are 15 cases. After I saw that the child's offspring or parents had a short body." (R8)

The results of the FGD regarding follow-up efforts for stunting management are through increasing caregivers' knowledge and providing additional food that meets nutritional standards. These results are outlined in the themes below.

“The effect of biscuits on reducing stunting is not very significant. The Ministry of Health provides a program for providing additional food from local ingredients which is managed by cadres. "To provide additional food to pregnant women with Chronic Energy Deficiency, it is given for 90 days, but we at the health center are still in the process of providing additional food." (R10)

“Personally, I think it has very big implications because the real control of the household rests with women. That how women at least have intelligence in managing the management of their household, whether from 0 or a to z, women play a very important role in that, so how do we try to educate women or mothers-to-be in particular, so that how do we try to really be able to manage household well." (R11)

The results of interviews related to follow-up screening for domestic violence in basic health service facilities, especially community health centers and PMBs, showed that midwives have an important role as women's friends. By conducting screening, midwives can provide recommendations to women to take the right steps, as well as educate their families, especially husbands, from an early age through classes for pregnant women. This is outlined in the themes below.

"Related to all of that, how can midwives carry out screening? I think midwives are the spearhead where midwives are women's friends. So with a midwife, women will be much more open in expressing existing problems." (R11)

"We have coordinated with women's empowerment institutions so that later our friends at the community health center, supporting community health center or posyandu can carry out screening earlier and the expected results from the screening in the future, once the results are available, can produce something useful for mothers, especially in reducing stunting. ”. (R12)

Respondents, when asked to state reasons for remaining in their marriage and experiencing violence, almost all of them said that they remained for the sake of their children and economic dependence, and that they were embarrassed if they had to burden their family and parents. As a result of in-depth interviews with women of childbearing age or respondents, three main themes were obtained regarding the history of DV that they had experienced in the last 12 months. The three themes include: culture, compliance and loyalty. The culture that is understood to be related to DV incidents is patriarchal culture. Men in Balinese culture have a higher position in the family compared to women. Wife as possession or property. After marriage, the woman or wife will follow her husband and live with the husband's family or extended family. The obedience of women or wives will also be seen in conditions where women act as implementers of decisions taken by men or husbands. The wife must submit and obey her husband's decisions. Loyalty is a concept that Balinese women hold firmly. The wife must show loyalty through obedience to her husband and family. The value of loyalty is until death. Below are shown the results of interviews with respondents:

“Ït's okay for me to experience this condition, the important thing is that my child is safe. As a Balinese woman, it is difficult to return home. The important thing is, my husband remembers that coming home is enough”. (R3 A)

“My husband's income is low, not even enough for a few days, so I help out as a farm laborer or do odd jobs. If I have money, I usually hand it over to my husband, so he can manage it”. (R10 A)

´ If my husband has said A, I have to follow what he says. I'm afraid I won't follow. Including if the child is sick, where will he be taken to be examined”. (R 15 A)

“After marriage, we women must follow our husbands. I live with my in-laws, sister-in-law. Usually my in-laws often look after my children when I go to work”. (R 25 A)

The results of studies on the relationship between socio-economic status, especially poverty, and stunting are known to be very closely related. Low socioeconomic status is a factor that hinders families from getting better health services, limitations in fulfilling nutritional needs and low levels of education (2, 31, 38). Low socio-economic status triggers low levels of fulfillment of the need for environmental sanitation and clean water (3, 39, 40). The influence of parental education and knowledge, income and geographical location is quite significant regarding the incidence of stunting. Likewise, there is a relationship between the occurrence or history of DV and the demographic characteristics of respondents (3, 40–42). Previous studies found that stunting requires special strategies, such as early intervention against risk factors. Internal risk factors include chronic malnutrition, intrauterine growth retardation (IUGR), non-exclusive breastfeeding, and chronic infections. External factors include poor sanitation, poor water sources, low socioeconomic level of parents, and large number of family members living in one household (3, 40–42).

A history of childbirth, complications during pregnancy and childbirth, and the type of previous childbirth can trigger stunting. High parity and the low quality of antenatal care services are triggers for increased complications in the form of hypertension, as well as maternal infections and bleeding. Studies in Ethiopia found that the key factors in reducing stunting are increasing total agricultural crop yields, increasing the number of health workers, reducing open defecation behavior, increasing parental education, improving maternal nutrition, improving the family economy, and reducing the incidence of diarrhea (15, 17, 43–47).

Risk factors for stunting in children in developing countries are not being given exclusive breast milk, low socioeconomic status, low birth weight, low birth length, low maternal education, infectious diseases in mother and baby. Economy is a woman's ability to independently manage all her needs and make the right decisions for her survival individually and as a family member (2, 3, 17, 20, 39, 42, 48). Women's autonomy includes making decisions about where to obtain antenatal care, intranatal care, baby and child care, determining the number of children, organizing or managing household finances, fulfilling family nutrition and the decision to work or not. Women's autonomy is also related to women's ability to negotiate with partners/husbands and family, respect each other's rights and obligations, and be free from feelings of fear, intimidation, or gender subordination and injustice. Women's autonomy related to financial independence greatly influences their own welfare (as individuals), the welfare of their children and their families (22, 24, 49–51).

Efforts to prevent and reduce the incidence of stunting require various efforts and certain strategies, so as to obtain optimal results. Policies and strategies providing specific nutritional interventions, such as counseling regarding feeding, care and hygiene for infants and young children. The cycle of violence against women will never be eliminated if all levels of society do not recognize and understand this series of violence. DV or domestic violence is likened to candies of hell. Incidents of violence against women will continue to recur because women feel that their partners or husbands will change for the better, and it is women who must change, give in, and accept an apology from their husbands or partners (52–54).

The terminology of gender-based violence or Violence Against Women (VAW) that is commonly used is the domestic violence or DV model. There are several terms related to abuse or arbitrary actions (violence), and these terms are a form of gender-based violence, namely acts of violence by intimate partners or intimate partner violence (ITP). So, in this scientific oration, several terms from Domestic Violence (DV), Violence against women (VAW), partner abuse and intimate partner violence (IPV) will be used interchangeably. Various other impacts related to DV for women or DV victims are: increasing the risk of using drugs or illegal substances and smoking, suicidal thoughts and even the children of DV victims tend to experience anxiety disorders, depression and other mental health problems (7, 30, 41).

The results of the analysis showed that statistically there was no significant relationship between the history of DV and stunting in the respondent group (p > 0.05). However, practically the incidence of DV reduces women's health and well-being. Various study results obtained on a wide scale show that the impact of DV on women varies, from non-fatal to fatal impacts. The World Health Organization (WHO) has shown that violence experienced by women is not only a major health problem and has a direct impact because it causes injury and death. In addition, the impact of violent or arbitrary acts can contribute to the overall burden of disease as a risk factor for several other serious health problems. To date, violence by partners or husbands has consistently been reported to have a negative impact on women's health globally (6, 7, 14, 15, 32, 43, 53).

Violence perpetrated by intimate partners against women is still common in low- and middle-income countries and is very detrimental to women and the development of the girls affected. Policy and program efforts are needed to reduce the prevalence and impact of this violence (55–57). According to the results obtained, almost all of the respondents involved in this research had very low incomes or below the Regional Minimum Wage. Low socioeconomic status is a risk factor for stunting, as well as low parental education, geographical conditions and poor obstetric history such as hypertension, bleeding and a history of fetal growth disorders in the womb (24, 36, 55, 58, 59).

Various study results show that women with low autonomy more often become victims of arbitrary actions or abuse from their partners or husbands and closest family. On the contrary, if a woman has high or strong autonomy in the household, she can control her life and health care. In agreement with this, studies from India, Nigeria and other countries have consistently obtained results that women who are victims of physical, sexual violence and various other types of violence increase the likelihood of malnutrition in the form of stunting and underweight in children under five (22, 24, 49–51). Women who are victims of IPV and DV experience physical and psychological trauma which affects their ability to care for their children, including providing them with nutrition (49, 51, 60).

Recommendations

Continuous efforts are needed from various related sectors to improve maternal and child health, especially reducing the incidence of stunting in children under five. Policies and strategies by providing nutrition-specific interventions, such as counseling regarding feeding, care, and hygiene for infants and young children (34). Approaches from various sectors include: 1) the social protection sector or health financing guarantee; 2) agricultural sector; 3) education; 4) equitable development and reducing poverty; 5) women's empowerment; and 6) health sector.

Women who are independent have the ability to manage themselves and their families as a protective factor related to stunting. On the other hand, the lower the level of education, income and ability to manage the household are risk factors for becoming a victim of DV and the risk of having stunted children. The influence of patriarchal culture that is still attached to Balinese men is slowly being reduced through improving women's self-quality. Subordination with the shield of obedience, loyalty can be transformed into empowering oneself economically as well as ability, mindset and courage.

Funding

This research has been funded from the 2023 DIPA budget of the Ministry of Health of the Republic of Indonesia. With contract number BJ.01.03/PPK/7326/2023.

Acknowlegdment

We express our gratitude to the Director General of Health Personnel, Ministry of Health of the Republic of Indonesia and the Head of the Karangasem District Health Service, who have facilitated this research activity.

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History of domestic violence among women and incidence of stunting in rural areas in Bali Province, Indonesia

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Abstract

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Introduction

Methods

Data Collection

Data Analysis

Ethics

Results

Respondent Characteristics

History of being a victim of domestic violence in the last 12 months

The relationship between sociodemographic characteristics and the incidence of stunting

The relationship between a history of domestic violence and the incidence of stunting

Qualitative Results

Discussion

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