Disclosure of non-family
perpetrated violence by
conflict-affected women in
Kosovo
Anita Ravi, MPH
Gender Based Violence in
War Zones
Gender Based Violence (GBV):
Perpetration of harm, including physical, sexual, and
psychological violence and threats of violence,
originates from power inequities based on gender
roles most commonly directed against women and
children. (Ward and Brewer 2004)
In Context of War:
Heightened vulnerability to rape, sexual
exploitation, physical and mental health effects
both during and after armed conflict (Ward 2005)
Non-Family Perpetrators
Anyone perpetrator unrelated to the victim’s
family
Kosovo: A Brief Historical
Timeline
1989
Yugoslav President Slobodan Milosevic strips
Kosovo’s constitutionally established autonomy
1990
Ethnic Albanian leaders declare independence
from Serbia
Belgrade dissolves the Kosovo government
1993-97 Ethnic tension and armed unrest escalate
1998
Serb forces launch a brutal crackdown
*Civilians are driven from their homes
1999
NATO launches air strikes against Yugoslavia
Milosevic withdraws troops from Kosovo
UN sets up a Kosovo Peace Implementation
Force
http://news.bbc.co.uk/1/hi/world/europe/country_profiles/3550401.stm
Study Background:
2002 Kosovo Pilot Study
Location:
• Peja, Kosovo
Who:
• Women’s Wellness Centre (WWC)
• Reproductive Health Response in Conflict (RHRC)
Consortium
• U.S. Centers for Disease Control & Prevention (CDC)
• GBV researchers at the University of Arizona
Purpose:
• Assist the WWC in developing evidence-based
programming related to GBV
• Pilot test both a survey instrument and methodology for
measuring factors related to GBV during and after the
war
Background:
2002 Report Findings
Non-Family Perpetrated Violence during 3 Time Periods
Violence Type
Conflict
Displacement
Post-Conflict
Physical Violence
16%
27%
1%
Sexual Violence
16%
23%
2%
Most Common Types of Non-Family Perpetrated Violence
Moderate Physical Violence
Conflict
Displacement
Grabbed on body
11%
38%
Severe Physical Violence
Threatened with a weapon
77%
86%
Moderate Sexual Violence
Improper Sexual Comments
92%
97%
Severe Sexual Violence
Body Cavity Searches
4%
5%
Rape
0%
0%
Purpose
Quantitatively assess violence disclosure by
GBV victims in Kosovo following their
experience with non-family perpetrated
violence
1) Examine characteristics of violence
disclosure
2) Examine associations between conflictrelated factors and disclosure of violence to
informal and formal support sources
METHODS
Data Collection
Data Source:
2002 GBV Survey
Survey:
174-item, interviewer-administered questionnaire
Location:
Peja, Kosovo
Study Population
Criteria:
• Resident of one of nine selected villages in the
Peja region at the time of the survey
• 18-49 years
2-stage sampling method:
• Stage 1: Equal probability sample of households
was chosen (473 households)
• Stage 2: One reproductive-aged woman from
each household was randomly selected from a list
of all eligible female residents of the home, in
order of age (383 women)
Sample Population:
• Among the eligible women, 332 (87%) completed
face-to-face questionnaires
*Only participants who reported experiencing violence included in
analysis
Time Periods
Measures
Conflict period (1988-1999)
Incidents when the respondent was living at home before
displacement.
Displacement period
Time that a woman was displaced from here home to the time
that she returned
Disclosure of violence
“If you told someone about the incident, whom did you tell?”
Informal support sources
Any family member or friend of the respondent
Formal support sources
Persons affiliated with organized group
NGO workers
United Nations staff members
Women’s groups
police/local authorities
religious authorities
medical staff
Measures: Violence
Moderate physical violence
Slapped/Hit
Tied up/blindfolded
Grabbed on the body with force
Severe physical violence
Choked
Beaten/kicked
Threatened with a weapon
Shot at/stabbed
Physically disfigured
Abducted
Sexual violence
Receiving improper sexual comments
Internal body cavity searches
Forced to remove clothing /stripped of clothing
Forced/threatened with harm
Unnecessary medical examinations of private areas
Unwanted kissing
Touched/beaten on sexual parts of the body
Rape
Analysis
Calculations
Frequencies and percentages
Pearson’s chi-square tests
Fischer’s exact test
Statistical Significance
P.10
*multivariable analysis could not be used
RESULTS
Characteristics at time of
interview:
Age Ranges: 26-35 years (35%), 36-45 (28%),
18-25 (27%)
Highest level of education: primary school (77%)
Most married/living with partner (72%)
Pre-war Occupation: homemaker (54%), farming
(33%)
Main source of income:
– Support from partner/relatives (44%)
– No income (41%)
– Money from own work (8%)
Displacement Characteristics
DISPLACEMENT
Frequency
Percent (%)
3
.9
Threat to personal security/safety
228
68.7
War/civil conflict
98
29.5
Other
3
.9
6
1.8
1998
166
51.1
1999
153
47.1
0
5
1.5
1
146
44.0
2
113
34.0
3
47
14.2
4
16
4.8
5
5
1.5
Returned home to Kosovo
229
69.8
Village/camp attacked
80
24.4
Other
19
5.8
Main reason for leaving home
Did not leave home
Year first left Kosovo‡
1990-1997
Number of cities/villages/ camps lived in
Main reason for leaving first location of displacement§
Help-Seeking Associated
Statistics
Characteristic
Experienced violence perpetrated by
nonfamily member
% Who disclosed incident
Conflict
20%
(n= 65)
100%
Displacement
29%
(n=97)
88%
Type of Resource Used
Informal
Female Family Member
94%
62%
84%
73%
61%
34%
34%
44%
29%
34%
26%
94%
53%
6%
24%
91%
52%
9%
Religious Authority
6%
0%
Police/Local Authorities
0%
0%
Male Family Member (non-husband/partner)
Friend
Husband/Partner (if not present during incident)
Formal
Women’s Group
NGO workers
Medical Practioner
Association between Violence
Types and Disclosure
CONLFICT
N (%)
Type of violence
Physical only
Sexual only
Combination of violence
Physical only or sexual
only
Both
Type of physical violence
Only moderate
Any severe
DISPLACEMENT
N (%)
DID NOT
DISCLOSE
DID
DISCLOSE
P
VALUE
DID NOT
DISCLOSE
DID
DISCLOSE
P
VALUE
13 (56.5)
14 (75.0)
10 (43.5)
4 (25.0)
.32
32 (68.1)
11 (68.8)
15 (31.9)
5 (31.3)
0.96
25 (64.1)
14 (35.9)
43 (68.3)
20 (31.8)
29 (93.6)
2 (6.5)
11 (91.7)
50 (75.7)
1 (8.3)
16 (24.2)
.02
17 (94.4)
1 (5.6)
9 (100.0)
21 (65.6)
0 (0.00)
11 (34.4)
0.08
.008
.45
Associations between circumstances of
violent incident and disclosure
CONFLICT
DID NOT
DID
DISCLOSE DISCLOSE
Know perpetrator
No
Yes
Where attacks took place
Home
Away from home
On the road to Kosovo
On the road elsewhere
or Other
Threatened with death
during assault
No
Yes
Person with respondent
at time of incident
Alone
Not alone
45 (76.3)
3 (50.0)
14 (23.7)
3 (50.0)
26 (66.7)
22 (84.6)
---
13 (33.3)
4 (15.4)
---
28 (100.0)
20 (54.1)
0 (0.0)
17 (46.0)
2 (100.0)
46 (73.0)
Partner not present
Partner present
P
VALUE
DISPLACEMENT
DID NOT
DID
P
DISCLOSE
DISCLOSE VALUE
70 (76.9)
2 (50.0)
21 (23.1)
2 (50.0)
--53 (69.7)
19 (100.0)
--23 (30.3)
0 (0.0)
<.0001
21 (95.5)
51 (69.9)
1 (4.6)
22 (30.1)
.02
0 (0.00)
17 (27.0)
1.00
1 (100.0)
71 (75.5)
0 (0.0)
23 (24.5)
1.00
39 (78.0)
9 (60.0)
11 (22.0)
6 (40.0)
.16
54 (75.0)
18 (78.3)
18 (25.0)
5 (21.7)
.75
Children not present
Children present
27 (77.1)
21 (70.0)
8 (22.9)
9 (30.0)
.51
34 (85.0)
38 (69.1)
6 (15.0)
17 (30.9)
.75
Others not present
Others present
17 (94.4)
31 (66.0)
1 (5.6)
16 (34.0)
.03
18 (100.0)
54 (70.1)
0 (0.0)
23 (29.9)
.005
.18
.15
.25
.005
DISCUSSION
Summary of Key Findings
Similar trends across conflict and displacement
Consistently greater use of informal over formal support
sources
Women’s groups most common formal support source
Women who experienced both physical and sexual
violence were significantly less likely to disclose the
experience to formal support sources than women who
experienced only one of these types of violence
Significance of presence of other family members or
friends during the incident
Limitations
Experience with Violence and Study Population
Women who did not disclose violence not included
Do not know whether the decision to participate was
related to the women’s experience with violence
Women who experienced more severe forms of violence
may be underrepresented due to underreporting
Sampling, Sample Size
Due to the sampling methods used results are applicable
only to the women in the nine included villages and cannot
be generalized to the wider population
Relatively small sample size, precluding multivariate
analysis
Future Directions
Ways to help ensure that victims receive
comprehensive care and support in the aftermath of
their experiences of nonfamily-perpetrated violence
Prioritizing the development of and funding for GBVfocused women’s groups during war and its
immediate aftermath
Improving the support provided by commonly sought
sources of informal support such as family and
friends through educational outreach
Incorporate GBV-prevention aspects in program and
policy design
Acknowledgements
Co-Authors:
•
•
•
•
•
•
•
Michelle Hynes, MPH1
Jeanne Ward, CSW2
Mary Koss, PhD 3
Lauren Zapata PhD, MSPH1
Lumnije Deqani4
Jason Hsia, PhD1
Kathryn M Curtis, PhD1
1 Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta
GA
2 Nairobi, Kenya
3 Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson AZ
4 Women’s Wellness Centre, Peja Kosovo
The women of Kosovo who participated
in this study