The National Survey on Domestic Violence Against Women in Viet Nam

The National Survey on Domestic Violence Against Women in Viet Nam International Association for Official Statistics Da Nang, Viet Nam, 8-10 October 2014 Mr. Do AnhKiem Director of Social and Environmental Statistics Department, GSO, VN General Statistical Office (GSO), Viet Nam

Research Objectives - Direct • Obtain reliable estimates of the prevalence of DV against women in Viet Nam • Document the health consequences of DV against women • Identify the factors that may either protect or put women at risk of DV • Explore and compare coping strategies and services used by women to deal with DV

Research Objectives - Indirect • Build research capacity of all involved research team members and fieldworkers • Raise and increase awareness about DV and DV Law among participants and respondents • Contribute to cross-sectoral collaboration • Contribute to the development of a network of people committed to address DV

Research Team • GSO: Overall coordination + Leader for quantitative data collection and analysis • WHO Office in Viet Nam: Overall coordination and technical assistance • National experts from MOH, VASS, CIHP: Technical assistance for quantitative part + Leader for qualitative part + Data analysis and report writing • International expert: Technical expertise for quantitative and qualitative work

Steps for the Research ImplementationApril 2009  November 2010 • Negotiation of contracts with all concerned parties • Translation of all research materials & tools • Planning Workshop for training & team-building • Adaptation of all research materials & tools • Pre-testing and revision of questionnaires & guidelines • Training of fieldworkers • Data collection (quantitative, followed by qualitative) • Data entry and cleaning • Data analysis and report writing • Final revision of report • Dissemination and advocacy activities

Methodology • Methodology developed by WHO for a multi-country study on women’s health and violence against women. The tools include: Study Protocol, Ethical and Safety Recommendations, Questionnaire, Training Manual, Interviewer's manual, Supervisor's manual, Data processing manual, Data entry program and Code book. • Tools and materials are being adapted to the specific situation and needs of Viet Nam.

Methodology • The study has a quantitative and a qualitative component. • For the quantitative component, a survey was conducted in whole Viet Nam, with face to face interviews with a representative sample of women. It took place from December 2009 to January 2010

Methodology • For the qualitative component, a limited number of focus group discussions and in-depth interviews was done in selected provinces with men, with women who experienced DV, and with professionals or volunteers who work with women and men facing DV. It took place in April 2010 in the provinces of Ha Noi, Hue and Ben Tre

Sample for quantitative component (1) • Population based household (HH) survey • Household = group of people usually living and eating together, including domestic workers staying at least 5 nights/week and visitors who stayed the last 4 weeks or more. • In the survey, the household is the statistical unit. Eligible women are chosen to the survey through their HH. • One woman per household selected at random • Women from 18 to 60 years old • Sample size: 5,520 HHs with the objective to complete 4,600 interviews. • To account for sample loss, non-response, non-accessible HHs and HHs without women in eligibile age group, there will be a 20% oversample. Thus the plan is to survey 5,520 HHs.

Sample for quantitative component (2) • Sample area: whole country, divided into the 6 “economic region” of Viet Nam: • Red River Delta • Northern midlands and mountain areas • North central area and central coast area • Central highlands • South east • Mekong River Delta • The results of the survey will be representative for urban and rural areas in the 6 economic region of Viet Nam (12 strata)

Questionnaire The questionnaire for Viet Nam was adapted from WHO Multi-country Study quantitative questionnaire version 10 (Rev. 26 January 2005). It was adapted to the needs of Viet Nam and adapted from the lessons learned from most recent studies in Turkey and Tonga. It was pilot-tested in 2 provinces before it was finalized

Questionnaire The questionnaire includes sections as follows: • Characteristics of the households. • Section 1: Characteristics of the respondent and her community • Section 2: General health • Section 3: Reproductive health • Section 4: Children’s information • Section 5: Characteristics of the current or the last partner • Section 6: Attitudes towards gender roles • Section 7: Experiences of respondents and their partner violence

Questionnaire The questionnaire includes sections as follows: • Section 8: Injuries resulting from partner violence • Section 9: Impact of partner violence and coping mechanisms used by women • Section 10: Non-partner violence and violence against children • Section 11: Financial autonomy • Section 12: Anonymous reporting of childhood sexual abuse, respondent feedback

Safety and ethical issues • Safe name: “Women’s health and life experience” was used in all survey documents/ transactions… • Confidentiality • Support for interviewers and respondents • One woman per household • Venue for the interviews • One site, one day

Organization of the study FOR QUANTITATIVE COMPONENT: • Fieldworkers’ selection and training: • The selection criteria for field workers included being female and between 30 and 60 years old. • Previous experience in survey was required, so they were selected among the staff from Provincial Statistics offices and GSO. • Important skills sought were: ability to interact with all classes of people; non-judgmental attitude; maturity and life experience • Good interpersonal skills to build a rapport with interviewee; and experience in dealing with sensitive issues

Organization of the study Training: • Training based on the 3-weeks standardized training module developed by WHO. • Trainers: Members of research team, led by International Consultant.

Organization of the study • Objectives of the training: • To increase sensitivity of participants to gender issues • To develop a basic understanding of gender-based and domestic violence • To understand the objectives of the research • To learn skills for interviewing, taking into account safety and ethical guidelines • To become familiar with the questionnaire • Methods using in training: • Presentations by national and international experts • Detailed question by question explanation of questionnaire • Role plays • Field practice

Organization of the study 2. Fieldwork procedures: * To prevent exhaustion for interviewers, the survey strictly adhered relevant recommendations to violence against women (VAW) studies: - Each interviewer should not conduct more than about 100 interviews throughout the course of the survey. - In rural areas it is advisable to finish one EA in one day so that safety and confidentiality do not get compromised. - Each interviewer is expected to do 3 interviews on a day.

Organization of the study 2. Fieldwork procedures: • Venue for interview was a central neutral location, usually the commune centre; • To support for respondents, the interviewed women received reference materials, consisting of booklets showing services and resources for women who suffer from violence, and copies of leaflets related to general health issues such as breastfeeding and traffic injuries prevention. The materials should be mixed with materials on other general health issues so that whoever views the materials does not identify the real purpose of the survey (domestic violence).

Organization of the study 2. Fieldwork procedures: • In Field work: Encourage the field workers to keep a fieldwork diary to document key issues and how they were resolved during the fieldwork as stated in the survey manual • Prepare in advance some support systems for the field workers during the field data collection to ensure well-being of the field workers.

Organization of the study 10 teams of 5 fieldworkers each: • 1 supervisor is responsible for overseeing all activities of the team in each EA. • 1 field editor is responsible for checking through each questionnaire once it has been finished to ensure it has been filled in correctly. • 3 interviewers: The interviewer’s primary task is to conduct the face-to-face interviews with the females identified as being in scope of the survey.

Organization of the study 3. Mechanisms for quality control. To ensure high quality in data collection, four different levels of control were set up. • Editors and team leaders • Supervision trips from GSO • Supervision trips from GSO, national consultants and UN staff • Core research team with support from international consultant

Organization of the study FOR QUALITATIVE COMPONENT • To clarify and provide more in-depth information on the data collected through the quantitative survey. • Method: + Focus group discussions with women who experienced DV, and with men + in-depth interviews with professionals and volunteers.

Organization of the study FOR QUALITATIVE COMPONENT • Research sites: To include participants from different regions, three provinces representing northern, central and southern Viet Nam were chosen for the field work: Ha Noi (North), Hue (centre) and Ben Tre (south)

Organization of the study FOR QUALITATIVE COMPONENT: • Thirty in-depth interviews were conducted in each province with 5 women survivors of violence, 1 key informants from the Women’s Union, 1 health services, 1 police, 1 village leaders and 1 the Communist Party and with 10 women and 10 men in the community. • Four focus groups were held in each province with average people from villages, two with women and two with men, for each sex group covering two different age ranges.

Data analysis and report writing: 2010 • Team work, with research from different disciplines/sectors • Timeline: • Analysis and initial findings: April to July • Report writing workshop: July • Stakeholders consultation: August • Process of peer review and approval from Steering Committee: September-October • Launching event: 25 November 2010 for the International Day to Eliminate Violence Against Women

Impacts • The findings from the National Study on Domestic Violence such as prevalence rate were used when developing key messages and communication materials for further awareness raising and advocacy. • Intervention models on domestic violence prevention and response were developed based on the findings in selected provinces for nationwide application. • the study made significant impacts on those who were directly involved in the study such as the interviewers and the respondents

Impacts • The respondents at the end of the interview often said they felt valued and thankful for being heard and their awareness was changed by having participated in the survey: • “I feel a lot better having talked with you. I could not figure out why I told you all these secrets of my life that even my mother is not aware of. I thank you very much for listening to my unhappy stories. I’ll take your advice. I will not kill myself”.

Impacts • Many of the fieldworkers in the debriefing said they were also transformed through their experience in this study, making them rethink their own life and experiences: • “I have gained more experience and understanding about life and society and developed a better sense of responsibility for myself and my community to deal with cases of violence ... also I have become more self-confident and gained more courage”.

Lessons The Ethical and Safety Recommendations for Research on Domestic Violence Against Women was strictly applied to all survey procedures. • Safe name’ for the study:National Survey on Women's Health and Life Experiences instead of using title “Domestic violence survey”. - This title also would enable the respondents to explain the survey to others without raising suspicion. - This title also was used by the researchers and interviewers to describe the survey from the GSO to outside partners and local authorities.

Lessons Confidentiality: • All staff signed a confidentiality agreement on the final day of training as part of their work contract. • Only the team leader had access to the list with the women's names. Interviewers only received a code for each respondent to mark in each questionnaire so that respondents could be identified.

Lessons Informed consent:The invitation letter sent to selected women explained the elements in the informed consent: confidentiality, voluntary participation, right to refuse to answer, etc. Once the respondent and female interviewer were alone, further information on the real scope of the study was provided as part of the consent procedure. Support for interviewers: Two counselors with specific experience on research with women who suffered violence were available to support and counsel interviewers where needed. They also were involved in the supervision visits to the field.

Lessons Support for respondents: A pocket-sized booklet containing general information on domestic violence and available services for survivors in Viet Nam was especially prepared and printed to give to all of the women after the interview ended. One woman per household: In selected households with more than one eligible woman, only one respondent would be selected randomly so no one else in the household could be aware of the contents of the interviews

Lessons Venue for the interviews: Asking women to leave their homes for the interviews would ensure the safety of the respondents and would avoid unwanted interruptions and uncomfortable questions. All selected respondents received invitations to one communal place such as a health centre or a cultural house for the interview at a specific time. Interviewers Recruiting: Only female who is between 30 and 60 years old and has had experience in survey work was recruited as interviewers.

Lessons Interviewers training: Fieldworkers were trained to terminate or change the subject of discussion if an interview was interrupted by anyone, including children. One site, one day: To maintain confidentiality, survey teams were not permitted to spend the night in the same commune where interviews were conducted, especially in the rural areas.

Main findings • Prevalence rates for physical violence by husbands among ever-married women in Viet Nam were as follows: 32% had experienced physical violence in her lifetime and 6% had experienced physical violence in the past 12 months (current violence). • For sexual partner violence among ever-married women the lifetime and current prevalence rates were 10% and 4% respectively.

Main findings • For emotional partner violence among ever-married women the lifetime and current prevalence rate were 54% and 25% respectively. • Combining data for physical and sexual violence, 34% of ever-married women reported that she had experienced physical or sexual violence by a husband at least once in her life, whereas 9% reported physical or sexual violence in the 12 months preceding the interview.

Main findings • Combining data for the three types: physical, sexual and emotional violence: 58% reported at least one of these types in her lifetime and 27% reported any of these types in the past 12 months • About 10% of the women in Viet Nam reported an experience of physical violence by someone other than a partner since they were 15 years old, • Only 2.3% of all women reported sexual violence since they were 15 years old.

Main findings • Only 2.8% of all women reported sexual abuse before they were 15 years old. • Fully 26% of women who ever had been physically or sexually abused by a partner reported having been injured because of the violence. • Fully 87% of abused women never sought help from formal services or people in authority. • About 60% of the women said that they had heard about the DV Law. end

Thank you!

The National Survey on Domestic Violence Against Women in Viet Nam