Title: An analysis of changes in the prevalence and patterns of intimate partner violence against
women in seven Asian countries
Version: 1 Date: 02 May 2023
Reviewer's report:
I commend the authors on this timely and well-conducted assessment in changes in prevalence
estimates of physical and sexual intimate partner violence over time points in seven Asian
countries.
A few minor comments:
• Please avoid the term “rate”, as what you are assessing are time point estimates (prevalence)
rather than a measure of frequency (rate).
• Similarly, I would caution against using the term trend throughout the manuscript as two
countries only have two time points, which is inadequate to assess trends.
• Depending on your word limit, you may consider elaborating how “deeper analyses into types
and severity of violence revealed that overall prevalence [estimates] hid more complex patterns”
• On p. 4, you mention that 8 out of 19 countries in the Asia region have >1 survey year, however
only 7 are used in the present analysis. What happened to the 8th country?
• Suggest that you incorporate greater discussion on and more citations for WHO methodology
in the methods section.
• You include all indicators of SV, even if they are not directly comparable across survey years.
I strongly encourage the authors to include only survey items that are directly comparable across
survey years. Failure to do so will lead to bias in comparison of estimates. For example, I
expect these changes in survey items influence why you find some forms of violence (e.g. SV)
increasing over time (not surprising – more items will likely lead to greater prevalence of a
composite measure of SV). So these methodological choices are very likely influencing the
interpretation you can make from changes in prevalence estimates between survey years.
• Why are table cells blank for cohabiting relationships in South Asian countries (Table 1)?  In
results section, it notes that virtually no women were in a cohabiting relationship – not than no
women were. Please align results discussion with what is in the Tables.
• Where is the mean age and mean age at 1st marriage/cohabitation for Viet Nam? (Table 1)
• “The rates of lifetime and current violence in Nepal and Pakistan (data for overall violence
available for the second time point only) were more similar.” – two questions on this sentence:
what is overall violence? Does this refer to physical and/or sexual violence? Also, suggest
specifying that the prevalence estimates of lifetime and current violence in the two countries
were similar to each other.
• Notes section, Table 2 – why was the Mantel-Haenszel test used in Cambodia and Philippines
but not also India (the other country with three time points)?
• Was significance testing conducted on changes in severity of PV and changes by age group? I
would be interested to know whether some of these declines are statistically significant, or more
due to random variation in the sample, and thus non-significant. That would have implications
for interpretation.
• When reporting declines, I encourage you to specify that you are comparing first and last time
points, where applicable (e.g. “In South Asia, the proportion of women who experienced severe
physical violence in their lifetime declined in each country”
• A final suggestion for your discussion: new studies have come out using DHS data that
show how attitudes condoning physical IPV are declining worldwide, while attitudes condoning
sexual IPV remain stagnant. This may help to explain why you see more clear declines in
prevalence estimates of physical IPV but a more mixed picture with respect to sexual IPV as the
normative environment around one form of violence changes, while the other does not.