Prevalence of Intimate Partner Violence in Thailand

Abstract

There is no recent national data on the prevalence of intimate partner violence in Thailand. This study proposed to examine the prevalence of intimate partner violence in 4 regions of Thailand by using a standardized questionnaire from the WHO multi country study on women’s health and domestic violence. Two thousand four hundred and sixty-two married or cohabiting women aged 20–59 years were interviewed about their experiences of psychologically, physically, sexually violent, and/or controlling behaviors by their male partners. The study found that 15% of respondents had experienced psychological, physical, and/or sexual violence in their life time which suggests that 1 in 6 of Thai women have faced intimate partner violence. Of the 15% of women who reported intimate partner violence within the past 12 months, psychological violence was the most common (60–68%), followed by sexual violence (62–63%) and physical violence (52–65%). In addition, the percentage of women who faced various forms of controlling behaviors varied from 4.6% to 29.3%. Men who were more controlling were more likely to abuse their female partners. The results reveal that partner violence against women is a significant public health issue in Thai society that must be addressed.

Full text

ORIGINAL ARTICLE
Prevalence of Intimate Partner Violence in Thailand
Montakarn Chuemchit
1
&Suttharuethai Chernkwanma
1
&Rewat Rugkua
2
&Laddawan Daengthern
3
&
Pajaree Abdullakasim
4
&Saskia E. Wieringa
5
Published online: 7 April 2018
#The Author(s) 2018
Abstract
There is no recent national data on the prevalence of intimate partner violence in Thailand. This study proposed to examine the
prevalence of intimate partner violence in 4 regions of Thailand by using a standardized questionnaire from the WHO multi
country study on women’s health and domestic violence. Two thousand four hundred and sixty-two married or cohabiting
women aged 20–59 years were interviewed about their experiences of psychologically, physically, sexually violent, and/or
controlling behaviors by their male partners.The study found that 15% of respondents had experienced psychological, physical,
and/or sexual violence in their life time which suggests that 1 in 6 of Thai women have faced intimate partner violence. Of the
15% of women who reported intimate partner violence within the past 12 months, psychological violence was the most common
(60–68%), followed by sexual violence (62–63%) and physical violence (52–65%). In addition, the percentage of women who
faced various forms of controlling behaviors varied from 4.6% to 29.3%. Men who were more controlling were more likely to
abuse their female partners. The results reveal that partner violence against women is a significant public health issue in Thai
society that must be addressed.
Keywords Intimate partner violence .Domestic violence .Thailand .National prevalence
Violence against women is a significant problem and a uni-
versal phenomenon around the world, including in Thailand.
One in 3 (35%) women around the world have experienced
physical and/or sexual violence by their partner in their life-
time (WHO 2016). The United Nations defines violence
against women as any acts of violent behavior that results in
physical, sexual or psychological harm to women (UN 1993).
There are many forms of violence against women. One of the
most common forms is Intimate Partner Violence (IPV)
(WHO 2002). IPV is a major public health issue, a hidden
social problem, and women’s human rights violation (WHO
2016), (WHO 2005a) which negatively affects women’sphys-
ical, mental, sexual and/or reproductive health (WHO 2016).
Intimate Partner Violence in Thailand
In Thai society, IPV is considered as a private issue and family
matter because the family is an important social institution,
and portrayed as a space of love and care, however, in reality
family violence exists. Most Thais learn they should not tell
outsiders about internal family matters. As a result, IPV re-
mains an invisible and unrecognized issue in Thai society and
women victims have to deal with their intimate violence in
their lives alone (Archavanitkul et al. 2005). When violence
occurs in families, it is not reported, thus the statistics on IPV
in Thailand are likely to be underestimated. Most of IPV sta-
tistics in Thailand are reports from Government Organizations
(GOs) and Non-Government Organizations (NGOs) such as
the One Stop Crisis Centre (OSCC). The OSCC is run by the
Ministry of Public Health and is a unit in government hospi-
tals aimed to assist victims of violent situations from police
station, NGOs’and shelters. Individuals who notify the police
or visit a hospital are likely severe cases of violence. Statistics
*Montakarn Chuemchit
Montakarn.ch@chula.ac.th
1
College of Public Health Sciences, Chulalongkorn Univerisity,
Institute Building 2, Phayathai Road, Patumwan, Bangkok 10330,
Thailand
2
The Royal Thai Ministry of Public Health, Nonthaburi, Thailand
3
Faculty of Nursing, Naresuan University, Phitsanulok, Thailand
4
Faculty of Public Health, Burapha University, Chonburi, Thailand
5
The Amsterdam Institute for Social Science Research, University of
Amsterdam, Amsterdam, The Netherlands
Journal of Family Violence (2018) 33:315–323
https://doi.org/10.1007/s10896-018-9960-9
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show that the numbers of domestic violence cases have sig-
nificantly increased from 25,767 to 31,866 between 2010 and
2013 respectively (Thai Health Promotion Foundation 2011),
(The Women's Affairs and Family Development 2013). In
addition, the report from the OSCC, Ministry of Public
Health (MOPH) found that, in 2015, there were 23,977 wom-
en who used their services. Furthermore, there were 460 cases
of partner violence wherein police were notified and 373 cases
which were sent to the court (The Women's Affairs and
Family Development 2015).
To address intimate partner violence, in 2007, Thailand
launched BDomestic Violence Victim Protection Act, B.E.
2550^and amended the criminal law B.E. 2550 section 276
(Penal Code Amendment Act (No.19) B.E. 2550 (2007)
2007). The BDomestic Violence Victim Protection Act, B.E.
2550^comprises 18 sections; many sections are important to
victims, perpetrators, and government officers. For example,
section 4states that BWhoever conducts any act of domestic
violence or is said to commit domestic violence shall be liable
to imprison for a term of not exceeding six months or to a fine
of not exceeding six thousand Baht or both^;section5stats
that BA domestic violence victim or a person who has found or
known of domestic violence shall have the duty to notify a
competent official for the execution of this Act..^Prior to
2007, the criminal law B.E. 2550 section 276, did not include
marital rape as a crime so spouses were not legally protected
against sexual abuse by their partner (Penal Code Amendment
Act (No.16) B.E. 2546 (2003) 2003). However, changes to the
law in 2007 added legal protection for spouses who are
victims of sexually violence by their partner.
Intimate Partner Violence Research in Thailand
The WHO Multi-country study on Women’s Health and
Domestic Violence Against Women (2005) examined the
prevalence of intimate partner violence in 10 countries:
Bangladesh, Brazil, Ethiopia, Japan, Namibia, Peru, Samoa,
Serbia, Tanzania, and Thailand.
The study found that of the 24,097 women participants,
16.0% to 61.0% had experienced some act of physical partner
violence in their lifetime. Sexual violence was reported by
6.0% to 58.0% of respondents. In addition, 16.0% to 69.0%
of women reported that they had experienced either sexual
and/or physical violence by their partners. In Thailand, the
study found that 22.9% of women in urban areas reported
physical violence, 29.9% reported sexual violence, and
41.1% reported physical or sexual violence, or both.
Whereas, 33.8% of women in rural areas reported physical
violence, 28.9% reported sexual violence, and 47.4% reported
physical or sexual violence, or both. It is interesting to note
that urban Thai women reported more sexual violence than
physical violence. The percentage of both urban and rural
women revealing one or more acts of controlling behaviors
by male partner varied from 4.7% to 31.3%. Furthermore, in
all settings, women who had experienced either physical and/
or sexual violence regularly reported more emotional suffer-
ing and identified physical health issues such as pain (WHO
2005b).
In 2006, there was a cohort study on domestic violence
among pregnant Thai women in one province. They recruited
421 women in third trimester of pregnancy and followed them
until 6 weeks postpartum. The study revealed that 53.7% re-
ported psychological violence, 26.6% faced physical violence,
and 19.2% confronted sexual violence by their partner during
the current pregnancy. Whereas, in the postpartum period re-
spondents who had experienced some type of intimate partner
violence ranged from 9.5% to 35.4% (Sricamsuk 2006).
The latest National Reproductive Health Survey from 2009
(Social Statistics Bureau 2010) revealed that the rate of inti-
mate partner violence among Thai women across the country
was 2.9%. More recently, Chuemchit and Perngparn (2014)
reported that between July –December, 2010 there were 471
women in Bangkok city who used the services at One Stop
Crisis Centre and more than 70% of women had been victim-
ized more than once (Chuemchit and Perngparn 2014).
These data are the tip of the iceberg; the true extent of the
issue cannot be seen. In Thailand, there have been no large-
scale IPV prevalence studies since the 2005 WHO Multi-
country study on Women’s Health and Domestic Violence
Against Women. In response, the aim of this study was to
examine the current prevalence of the various forms of inti-
mate partner violence, including physical, psychological, sex-
ual violence, and controlling behaviors and to identify factors
associated with partner violence.
Method
Participants
This study was a cross-sectional study in 4 regions of
Thailand: central, northern, southern, and northeastern which
are the official government-categorized zones. A multi-stage
sampling technique was used; first, simple random sampling
was used for selection of one province in each region, second,
all districts from the region were chosen for the study.
The sample size was calculated by n
stra
=N∑Nhπh1−πh
ðÞ
N2D2þ∑Nhπh1−πh
ðÞ
,
π= The proportion of IPV in Thailand (5.13%), based on
National Statistic Office 2006. Therefore, a total sample size
of 2,462 eligible persons was sought. Then the sample was
calculated as proportionate to the size of each province and
district. Finally, convenience sampling was used to select the
participants at each community site. At the community level,
first, researchers went to see a community leader to request the
names and addresses of married or cohabiting women.
316 J Fam Viol (2018) 33:315–323
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Second, researchers visited women’s houses based on the list
to conduct interviews. All eligible women we met were select
as respondents. While both men and women can be victims,
women are more likely than men to face various forms of
partner violence and report IPV-related injury (Hegarty
2000), (Breiding et al. 2008), (Tjaden and Thoennes 2000).
Therefore, this study focused on women age 20–59 years, still
married or cohabiting with a partner, and willing to participate
in the study. Table 1provides a brief description of the study
areas.
Procedure and Data Collection
Each province had research assistants under the supervision of
the principal investigator. In order to ensure quality data was
captured, the female research assistants recruited for the data
collection had at a minimum a bachelor degree, worked in the
area of public health, and were experienced in community-
based research. In each site, the interviews were conducted
by trained interviewers who passed the standardized training
based on WHO women’s health and domestic violence study
(Jansen et al. 2004) covering issues of gender-based violence
and its consequences, gender sensitivity, interviewing tech-
niques and skills, ethic, and the questionnaire. To ensure the
confidentiality and safety of participants, each participant had
a separate and private interview by a trained female interview-
er. All these processes were intended to protect the privacy of
the participants and minimize the shame of respondents for
disclosing details of their relationship. After finishing the in-
terview, all respondents received useful information about
available services, for instance, hotline call center, shelter
houses, and OSCCs in each province. Interviewers also pro-
vided respondents with additional support from local health
service providers if requested. The data collection was con-
ducted in 2016.
Ethical permission for this study was obtained from the
Ethics Review Committee for Research Involving Human
Research Subjects, Health Science Group, Chulalongkorn
University (COA No.201/2016), Thailand.
Measurement Tool
A questionnaire was developed from the WHO multi country
studyonwomen’s health and domestic violence
(Archavanitkul et al. 2005), (Garcia-Moreno et al. 2006).
The WHO multi country study onwomen’s health and domes-
tic violence, measures three items of Bsexual abuse^, six items
of Bphysical abuse^,fouritemsofBpsychological abuse^,and
seven items of Bcontrolling behaviors^which were examined
separately from psychological abuse. After the pre-test, the
Cronbach alphas for this measurement tool was 0.94.
The participants were asked questions related to their ex-
perience of specific acts of psychological, physical, and sexual
abuse by their current husband and/or cohabiting male partner.
Furthermore, we also followed the WHO framing of the ques-
tions which highlighted Bhow partner’s treat each other rather
than so-called conflict negotiation^(Garcia-Moreno et al.
2006), (Heise and Garcia-Moreno 2002) because much inti-
mate abuse in the Thai context can be conceptualized as
punishment.
The questions on psychologically violent acts focused on
insulting, humiliating, scaring, and threatening behaviors. The
questions on physically violent acts were categorized as: 1)
mild-to-moderate violence and 2) severe violence based on
physical injury. Mild-to-moderate violence included pushing,
shoving, grabbing or slapping and severe violence included
choking, kicking, or using a weapon (WHO 2005b)(see
Tab le 2). Sexually violent acts included using physical force
for sexual intercourse, having sexual intercourse against
women’s will, and sexual humiliation. For each act of vio-
lence, each participant was asked whether it had occurred over
a year ago or within the year and then asked about the fre-
quency of each act: 1) once or twice 2) a few times or 3) more
than five times. The lifetime prevalence of IPV was defined as
women who reported any kind of violent experience by a
Table 1 Study sites by region and
province* Region Female population
(20–59 years old)
Province Sample size
Central 5,113,691 Chonburi: Famous province for Oceanside. Lots of
factory and tourism business. 80 km from Bangkok
725
Northern 3,644,532 Phitsanulok: 383 km from Bangkok. Mountainous area
mostly in Agriculture
457
Southern 2,659,222 Surat Thani: Large City in the region. Center for tourism
along seaside. Mostly in tourism and fishery business.
639 km from Bangkok
378
Northeastern 6,595,363 Khonkaen: Big city and the center of northeastern.
Mostly in agriculture and tourism service business.
449 km from Bangkok
902
Tot a l 246 2
*Thailand consist of 77 provinces
J Fam Viol (2018) 33:315–323 317
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current partner over a year before the interview. Current prev-
alence was defined as women revealing at least one act of
partner violence during the past year.
In addition, this study also focused on seven forms of con-
trolling behaviors by women’s male partners which consisted
of various acts to force and restrict women’s daily life. For
each act of controlling behavior, each respondent was asked
whether it had happened within the past year (Yes or No).
BYes^responses were given a score of one and BNo^re-
sponses were given a score of zero. Total scores were catego-
rized into four levels (Garcia-Moreno et al. 2006): (1) None
(2) low (3) medium and (4) high.
Data Analysis
All data was entered, cleaned and coded before analyzing.
Statistical Package for Social Sciences (SPSS Version 22)
was used to perform Uni-variate, Bivariate, and multivariate
analysis. Uni-variate analysis was used to describe and sum-
marize variables and find patterns in the data. (e.g. frequen-
cies, percentages, means and standard deviation). Bivariate
and multivariate analysis were used to test relationships be-
tween variables. For bivariate analysis, Pearson’s Chi square
test with statistical level of Pvalue <0.05 was used to analyze
the association between controlling behaviors by male partner
and experiences of violence. Multivariate regression was used
to examine differences in lifetime IPV by demographic
variables.
Results
In this study, four provinces from 4 regions were sampled
according to the proportion of the population. The mean
age of the respondents was 39.4. Thirty-four percent of wom-
en had finished higher education, the rest had completed
high-school, primary school, secondary school, and no
education, respectively. About 10.7% of participants were
housewives and/or no occupation, while 89.3% had an occu-
pation (See Table 3).
Table 2 Items of the questionnaire used to define psychological, physical, sexual violence, and controlling behaviors by intimate male partner
Psychological violence Physical violence Sexual violence Controlling behaviors
Insulted or made feel bad
about oneself
Mild-to-moderate: Physically forced you to have sex
when you did not want
Tried to keep you from seeing friends
Humiliated or belittled in
front of other people
Slapped or threw something
that could hurt
Had sexual intercourse when did
not want because afraid of what
partner might do
Tried to restrict you to contact your family
Did things to scare or frighten Pushed or shoved Was forced to do sexual activity
that degrading or humiliating
Insisted on knowing where you were at all times
Threatened to hurt you or
someone you care about
Severe violence: Ignored you and treated you indifferently
Hit with fist or something
that could hurt
Got angry if you spoke with another man
kicked, dragged, or beaten up Was often suspicious that you were unfaithful
Chocked or burnt Expected you to ask permission before going out
Threatened to use weapon
Table 3 Selected socio-demographic characteristics of 2462 married/
cohabiting women of the 4 regions of Thailand
Characteristics n (%)
Province (n= 2462)
Chonburi 725 (29.4)
Phitsanulok 457 (18.6)
Surat Thani tourism 378 (15.4)
Khonkaen 902 (36.6)
Age (n=2441)
20–29 years 487 (20.0)
30–39 years 712 (29.2)
40–49 years 766 (31.4)
50–59 years 476 (19.5)
Mean ± SD 39.4 ± 10.2
Range 20–59 years
Education (n= 2396)
No education 25 (1.0)
Primary 576 (23.5)
Secondary 398 (16.3)
High school 608 (24.8)
Higher education 840 (34.3)
Occupation (n= 2458)
Housewife/ no occupation 262 (10.7)
Agriculture 521 (21.2)
Permanent employee 682 (27.7)
Temporary employee 144 (5.9)
Business owner 242 (9.8)
Company staff 221 (9.0)
Government officer 338 (13.8)
Other 48 (1.9)
318 J Fam Viol (2018) 33:315–323
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Results demonstrate that out of 2,462 respondents, 15.4%
had encountered psychological, physical, or sexual violence,
suggesting that 1 in 6 married or cohabiting Thai women have
experiences intimate partner violence in their lifetime (See
Tab le 4).
Tab le 5reflects the proportion of married/cohabiting wom-
en who disclosed having experienced psychological, physical,
or sexual intimate partner violence in their lifetime(over 1 year
ago) or currently (within the past year). The study revealed
that the most commonly reported type of partner violence was
psychological violence. Sexually violence by a partner was
noticeably less prevalent than the other 2 types of violence.
Mild to moderate physical violence were more prevalent than
severe physical violence.
The most common form of psychological violence was
being scared (15.4%), followed by being insulted (14.8%),
being humiliated or belittled (10.9%), and being threatened
(7.5%). Reports of physical violence included being pushed
or shoved (10.6%), follow by being slapped or thrown (8.3%),
being hit with a fist (5.4%), being threatened with a weapon
(4.4%), being kicked/dragged/beaten up (4.1%), being
chocked/burnt (2.6%). Reports of sexual violence, found that
10.4% of respondents revealed unwanted sexual intercourse,
5.4% were physically forced to have sex and 3.3% were
forced to do sexual activities that were degrading or
humiliating.
There were considerable differences between the propor-
tion of women who experienced lifetime violence and current
violence. More than 60% of respondents faced all forms of
psychological violence and all forms of sexual violence in the
past year, more than half (>50%) had experienced both mild to
moderate and severe physical violence in the past year as well.
The lifetime prevalence of IPV varied by the type of vio-
lence experienced. Psychological violence varied from 31.6%
(threatened to hurt you or someone you care about) to 39.6%
(humiliated or belittled in front of other people); physical vi-
olence varied from 34.9% (chocked or burnt) to 47.5%
(pushed or shoved); whereas, sexual violence varied from
36.2% (was forced to do sexual activity that was degrading
or humiliating) to 37.4% (physically forced you to have sex
when you did not want). Most respondents reported repeated
acts of IPV.
Tab les 6and 7show the proportion of married/cohabiting
women who reported having experienced controlling
behaviours by an intimate partner and highlight the associa-
tion between experiences of violence and controlling behav-
iours. The most frequently reportedact of controlling behavior
by a male partner was Binsisted on knowing where the female
partner was at all times^(29.3%) followed by Bgot angry if
female partner spoke with another man^(28.5%), Bsuspicious
that female partner is unfaithful^(21.3%), Bignored and treat-
ed indifferently^(16.5%), Bkeeps female partner from seeing
friends^(15.2%), Bexpected female partner to ask permission
before going out^(10.7%), and Btried to restrict female part-
ner to contact your family^(4.6%).
The percentage of women who reported one or more acts of
controlling behaviors by their male partner varied from 13.5%
to 39.3%, which suggests that the level of male control over
female behavior is normative to a certain degrees. The respon-
dents who had experienced IPV were significantly more likely
to have also experienced controlling behavior by their male
partner than women who had not faced partner violence.
Tab le 8illustrates multivariate logistic regression models to
determine relationships between lifetime IPV victimization
and demographic variables. There were significant differences
in IPV prevalence among provincial settings. Compared to
women in Chonburi province (central), Phitsanulok province
(northern) were significantly more likely to have experienced
lifetime IPV victimization (OR 2.34; 95% CI = 1.34–4.06).
Women who worked in Bwhite collar^occupations were sig-
nificantly less likely to report lifetime IPV victimization than
Table 4 The proportion of married/cohabiting women who revealed
facing violent experiences by male partner
Experiences of violence n (%)
Never 2,083 (84.6)
Ever 379 (15.4)
Table 5 Lifetime (over 1 year ago) and current prevalence (with past
year) of psychological, physical, or sexual intimate partner violence
among married/cohabiting Thai women
Violent Act Abused
women
(%)
Over
1year
ago (%)
Past
year
(%)
Psychological
Insulted or made feel bad (14.8) (39.5) (60.5)
Humiliated or belittled (10.9) (39.6) (60.4)
Did things to scare (15.4) (38.1) (61.9)
Threatened to hurt (7.5) (31.6) (68.4)
Physical
slapped or threw (8.3) (40.6) (59.4)
Pushed or shoved (10.6) (47.5) (52.5)
hit with fist (5.4) (46.9) (53.1)
kicked, dragged, beaten up (4.1) (40.4) (59.6)
Chocked or burnt (2.6) (34.9) (65.1)
Threatened to use weapon (4.4) (43.4) (56.6)
sexual
physically forced you to have sex (5.4) (37.4) (62.6)
Had sexual intercourse because afraid of (10.4) (37.3) (62.7)
was forced to do sexual activity that
degrading or humiliating
(3.3) (36.2) (63.8)
J Fam Viol (2018) 33:315–323 319
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women who worked in Bblue collar^occupations (OR 0.66;
95% CI = 0.52–0.85). Women who completed higher educa-
tion were significantly less likely to report lifetime IPV vic-
timization than those who had no education and those who
completed only primary education (OR 0.37; 95% CI = 0.15–
0.91) and (OR 0.66; 95% CI = 0.49–0.89), respectively).
Women who had sufficient income and savings were signifi-
cantly less likely to report lifetime IPV victimization than
those who had insufficient income and those who had suffi-
cient but no saving (OR 0.26; 95% CI = 0.17–0.41) and (OR
0.46; 95% CI = 0.30–0.72), respectively).
Discussion
According to this study 15.4% of married/cohabiting Thai
women have experienced psychological, physical, and/or sex-
ual intimate partner violence at some point in their lives. This
number is considerably higher than the latest National
Reproductive Health Survey in 2009 (Social Statistics
Bureau 2010), which found that the national prevalence of
partner violence among Thai women was 2.9%. This wide
discrepancy in results could be due to the measurement tool.
The 2009 survey asked only one question about experience of
physical partner violence in the past 12 months, if the response
was yes, then there were 2 following questions: 1) what was
the reason for the violence and; 2) have you ever asked for any
help. This single question is a limitation of the previous survey
because intimate partner violence can be psychological, phys-
ical, and/or sexual violence and surveys should ask
behaviorally specific questions in order to encourage respon-
dents to disclose the entire scope of their violent experiences
(Garcia-Moreno et al. 2006), (Straus et al. 1996), (Ellsberg
et al. 2001).
This study also showed that across the country, psycholog-
ical violence had the highest prevalence followed by physical
violence and then sexual violence. Similar findings have been
recorded in the WHO multi-country study (Garcia-Moreno
et al. 2006)onwomen’s health and domestic violence, across
10 countries, sexual violence was greatly less prevalent than
physical violence. However, Thailand was an exception with
rates of sexual violence higher than physical violence in the
WHO multi-country study. Forty-four percent of women in
the city and 29% of women in the province had experienced
sexual violence by their partner (Archavanitkul et al. 2005),
(Garcia-Moreno et al. 2006), (Heise and Garcia-Moreno
2002).
To explain these contradictory results, we had look back
over the past decades, particularly the Thai policies and cam-
paigns on IPV prevention. For example, BDomestic Violence
Victim Protection Act, B.E. 2550^and BAmended the crimi-
nal law B.E.2550 section 276^. Prior to the amended law,
section 276 stated that Bany person who commits sexual in-
tercourse with a woman who is not his wife, and against the
latter’s will, by threatening her, or doing any act of vio-
lence…, shall be punished with imprisonment…^(Penal
Code Amendment Act (No.16) B.E. 2546 (2003) 2003).
However, changes to the law, by removing the sentence Bwith
a woman who is not his wife^, added protection to spouses
against sexually violence by their partners (Penal Code
Table 6 Portrays the proportion
of married/cohabiting women
who reported having experienced
controlling behaviours by an
intimate partner
Controlling behaviours n Ever Never
n%n %
Tried to keep you from seeing friends 2461 374 15.2 2087 84.8
Tried to restrict you to contact your family 2460 114 4.6 2346 95.4
Insisted on knowing where you were at all times 2462 722 29.3 1740 70.7
Ignored you and treated you indifferently 2461 405 16.5 2056 83.5
Got angry if you spoke with another man 2462 702 28.5 1760 71.5
Was often suspicious that you were unfaithful 2462 524 21.3 1938 78.7
Expected you to ask permission before going out 2462 264 10.7 2198 89.3
Table 7 Controlling behaviours
by intimate male partner reported
by married/cohabiting women
Number of married/
cohabiting women
Experiences
of violence
Act of controlling behaviours P* Number of
Act, mean
P
⍶
None
(%)
1
(%)
2or3
(%)
4–7
(%)
2,079 Never 56.2 17.7 17.9 8.2 1.0
379 Ever 21.6 13.5 25.6 39.3 <0·0001 2.6 <0·0001
The percentage presents controlling behaviours act regard to partner violence experience. *Pearson χ22×4table.
⍶ANOVA
320 J Fam Viol (2018) 33:315–323
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Amendment Act (No.19) B.E. 2550 (2007)2007). These tools
may gradually reduce the prevalence of sexual violence in
Thai society but do not appear to have had a major impact
over the last 10 years. However, today the campaigns related
to IPV prevention are rarely seen in mainstream Thai society.
All of the women who reported physical violence had ex-
perienced more violence in the past year than over her life-
time. These study results confirm that IPV is a common expe-
rience worldwide. In a Japanese city, the lifetime prevalence
of physical abused by an intimate partner was 13%, whereas,
inBangladeshicityitwas40%(Garcia-Morenoetal.2006).
In Vietnam, the prevalence rate of physical partner violence
was 30.9% (Vung et al. 2008). In Cambodia, 25% of women
interviewed experienced partner violence since marriage, with
23% disclosing such violence in the prior year (Yount and
Carrera 2006). Whereas, in Canada 6% of women revealed
having been abused by their male partner (McCormick et al.
2016). In the USA, 5.3% of postpartum women stated that
they were physically victimized by an intimate partner in the
year prior to becoming pregnant (Stewart et al. 2017). A WHO
Study recorded that the 12-month prevalence of partner vio-
lence was much higher in developing countries as compared
to developed countries such as Canada and the USA
(McCormick et al. 2016), (Stewart et al. 2017) which suggests
that a good legal framework, effective government cam-
paigns, sufficient shelters and women’s individual empower-
ment are important and provide a foundation from which
women have more resources to choose to withdraw from abu-
sive relationships. Findings that emphasize the importance of
resources and social status have been noted in Vietnam(Yount
and Carrera 2006) and others, and suggest that partner vio-
lence might be different in settings of low income and unem-
ployment status compare with higher socio-economic settings
(Mallory et al. 2016). Finally, controlling behaviors by male
partners were significantly associated with partner violence,
which is consistent with WHO findings showing that men
who are a perpetrators also show higher rates of controlling
behaviors than men who do not abuse their partner (Garcia-
Moreno et al. 2006). Therefore, resources to support women
coupled with campaigns to educate men and deemphasize
traditional gender norms may be critical to reducing rates of
IPV in Thailand.
Limitations
This study only asked about rates of IPV against women,
although women may also be perpetrators of violence in
relationships. However, research has consistently demon-
strated that men are the dominant perpetrators of violence
in relationships including married and cohabiting relation-
ships (Archavanitkul et al. 2005), (Garcia-Moreno et al.
2006), (Zhang et al. 2012). Some studies have documented
that women are almost eight times more likely to be vic-
tims of violence by a partner than men (Stuckless et al.
2015). Another limitation was this study based on self-re-
port, which may be affected by recall bias, as well as cul-
tural biases in disclosure which affect to participants’will-
ingness to reveal their violent experiences. We recognize
that in the Thai context, IPV is viewed as a family affair.
The privacy of the family in Thai society strengths gender
power imbalance and hierarchies that are often dependent
on the sustainability of male domination and violence
(Mohamad and Wieringa 2014). This research highlights
the prevalence of psychological, physical and sexual inti-
mate partner violence in Thai society. Although some dif-
ferences in prevalence were noted in the results according
to education, occupation, and number of partners these
differences did not account for the varying rates of vio-
lence across provinces.
Table 8 Relationship between lifetime IPV victimization and
demographic variables
Lifetime IPV
OR 95% CI
Province
Phitsanulok 2.335 1.34–4.06
Khonkaen 0.36 0.26–0.49
Suratthani 0.19 0.13–0.27
Chonburi Ref Ref
Age (years)
20–29 1.29 0.92–1.81
30–39 1.31 0.96–1.79
40–49 1.29 0.95–1.76
50–59 Ref Ref
Occupation
Housewife 1.78 0.52–1.15
Blue collar 0.66 0.52–0.85
White collar Ref Ref
Education
None 0.37 0.15–0.91
Primary school 0.66 0.49–0.89
High school 0.79 0.60–1.03
Higher education Ref Ref
Years o f c o n j u g a l l i v i n g
< 10 1.10 0.73–1.66
11–20 1.12 0.72–1.73
21–30 0.95 0.61–1.47
> 30 Ref Ref
Income
Insufficient 0.26 0.17–0.41
Sufficient but no saving 0.46 0.30–0.72
Sufficient and saving Ref Ref
J Fam Viol (2018) 33:315–323 321
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Strengths
This study had significant methodological strengths in-
cluding: using a standardized questionnaire, pre-testing
the questionnaire, training interviewers, and collaborating
with communities to account for the ethical complexities of
working on sensitive issues within communities in
Thailand. All these methodological techniques may help
to reduce bias in the study and increase disclosure.
However, we believe that in Thai culture, violence is a
deeply personal issue which likely leads to an underesti-
mation of the overall violence situation in Thai society.
Hence, the findings of this study should be thought of as
an underestimation of the actual rate of intimate partner
violence in Thailand.
Recommendations
This study confirms the high prevalence of intimate partner
violence in Thailand which is a serious human rights vio-
lation and highly significant public health issue as IPV is
linked to many negative health consequences. These re-
sults should encourage national action to prevent IPV and
contribute national data to a spectrum of interest groups
including policy makers, public health practitioners,
multi-disciplinary, educators, media, activists, and commu-
nities. National policy change should work to eliminate the
root causes of violence against women and re-build Thai
society as violence free society. For instance, the govern-
ment needs to prioritize the establishment of a special
agency solely responsible for providing a comprehensive
package of services to women suffering from various
forms of violence. The services must include: counseling,
shelter, rehabilitation and referrals to additional health and
social support services and professional sensitivity training
for multi-disciplinary practitioners on issues concerning
violence against women and the enhancement of a public
campaign through the mass media and social media to
eradicate all forms of violence against women. Moreover,
we must challenge social norms to ensure that domestic
violence is a public rather than a private issue and create
networks and community participation to prevent and to
monitor domestic violence in the community. Media mes-
saging should focus on promoting gender equity, respect
for human dignity and non-violent relationships. In partic-
ular, media should work to avoid reproducing structural
and cultural violence against women in media reporting
and avoid producing content that reinforces and motivates
violence.
Acknowledgments This research project is supported by the Thailand
Research Fund (2016).
Thank you to Dr. Marion Doull to revise and edit a final draft. Thank
you to everyone who partcipated in this study. Contributions made by all
participants are greatly appreciated.
Open Access This article is distributed under the terms of the Creative
Commons Attribution 4.0 International License (http://
creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
distribution, and reproduction in any medium, provided you give appro-
priate credit to the original author(s) and the source, provide a link to the
Creative Commons license, and indicate if changes were made.
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