title: Hidden voices: prevalence and risk factors for violence against women with disabilities in Nepal.
abstract: BACKGROUND
  There is an increasing body of evidence on the extent and predictors of violence against women in Nepal. However, much of the published research does not yet take into account additional features of marginalization and vulnerability suffered by some women - for example, women socially excluded on account of their disability. Critical gaps exist in empirical data on the extent, risk factors, access to care, socio-economic and health consequences of violence among women with disabilities in Nepal. This paper addresses some these gaps and aims to promote evidence-informed policy and programme responses in Nepal.
  
  
  METHODS
  We conducted a cross-sectional survey of 475 women with disability aged 16 years and above in three districts in Nepal. In-depth interviews with 12 women who reported violence in the survey were also carried out. Using multivariate statistical methods we estimated the prevalence and risk factors for violence experienced both over the past 12 months and lifetime.
  
  
  RESULTS
  Over the lifetime, 57.7% of women reported they had ever experienced violence, including emotional violence (55.2%); physical violence (34%); and sexual violence (21.5%). Over the preceding 12 months, 42% of women reported that they had experienced violence. Multivariate analysis showed that women with disabilities who were young, working in paid employment, and those who required permission from husbands/family to go to health centres or participate in community organizations were at increased risk of violence. Women experienced a range of negative outcomes from violence - including physical and emotional trauma. However, a majority of women did not seek care or redress from the health, justice or other sectors.
  
  
  CONCLUSIONS
  Women in Nepal are at high risk of violence, often from members of their immediate family or local community. Rates of violence are higher in women with disability than among women in the general population. Tackling violence requires a comprehensive approach that addresses the root causes of women's unequal position in society, and builds upon principles of equity and justice to ensure that all women are able to realize their rights to a life free from violence.
authors: Mahesh
authors: M
authors: Puri
authors: Geetanjali
authors: G
authors: Misra
authors: Sarah
authors: S
authors: Hawkes
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003625:Data Collection; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013179:Spouse Abuse / Q000706:statistics & numerical data*; D055815:Young Adult