Reviewer's report
Title:Change over time in factors associated with domestic violence by intimate
partner in Egypt: analysis of two surveys
Version: 1Date:21 January 2008
Reviewer: Farah Ahmad
Reviewer's report:
Manuscript Title: Change over time in factors associated with domestic violence
by intimate partner in Egypt: analysis of two surveys
This is an interesting paper and written well. The authors report prevalence of
domestic violence and help seeking patterns by analysing two Demographic and
Health Surveys (DHS) conducted in Egypt in 1995 and 2005. This study has the
potential to advance knowledge in the area of womenâ##s health from
epidemiological and public health perspectives. However, the paper needs
improvements as discussed below.
To meet the BMCâ##s reviewer guidelines, I have indicated â##Major
Compulsory Revisionsâ## with double asterisk (**), and â##Minor Essential
Revisionsâ## with a single asterisk (*). Other suggestions should be considered
â##Discretionary Revisionsâ##.
ABSTRACT:
1. * The method section should describe the type of statistical analyses used and
inclusion of weights for population estimates.
2. * The result section describes the results without actual numbers. Please
include actual numbers (e.g. the prevalence of domestic violence as xx% for
1995 and xx% for 2005)
BACKGROUND:
The authors present an in-depth review of the existing literature in a concise and
logical manner. This section needs some improvements as suggested below:
1. * In the 3rd paragraph on page 3, the authors state â##Egypt is a country with
both high prevalence of domestic violence compared to other countriesâ#¦â##. It
is important to give details of this previous work in Egypt, such as: what were the
rates of domestic violence reported in the previous studies? How were these
studies conducted? How was domestic violence measured? What are the
limitations? Why this new study is needed?
2. What is the new divorce law in Egypt?
3. The last sentence of paragraph 3 on page 3 has a typo: â##We assess more
in dept the effectsâ#¦â## should be â##We assess more in depth the
effectsâ#¦.â##
METHODS
1. Sample: A good overview of the DHS survey and its modules is presented.
Could you please tell the readers about some of these details: the response rates
of the two surveys; method of administration (in person interviews, phone
interviews, self-administered)?; completion time; language of the surveys; and
use/non-use of proxy interviews.
2. * Variables: The authors provide good details about the questions used in the
1995 and 2005 surveys to measure domestic violence and help seeking. Were
these questions coming from previously validated tools? Do we know the validity
and reliability of the translated versions?
3. As this is long a section, please make two sub-sections for the â##Key
variablesâ## and â##Socio-demographic variablesâ##.
4. ** The major limitation of this paper is the operationalization of the
â##domestic violenceâ## and â##help seekingâ##â## variables which were
measured differently in the two DHS surveys.
4.a. In 1995, the DHS survey measured â##beatingâ## while in 2005 the DHS
measured several types of domestic violence perpetrated by partners. These two
are NOT alike. The authors also acknowledge, though indirectly, and make an
attempt to explain their â##counterintuitiveâ## findings (page 7) by conducting
Factor Analyses of the 2005 version of the domestic violence questions. This
factor analyses found that the questions actually measure different forms of
violence: extreme, strong, and moderate violence. In my view, the 1995 item on
â##beatingâ## should be compared only with similar items included in the 2005
(e.g. â##extremeâ## and â##strongâ##). The analyses should be re-run with this
re-operationalized variable. It may resolve many counter intitutive findings in this
paper.
4.b. Likewise, â##help seekingâ## was measured differently in 1995 and 2005:
(i)The help-seeking item focused on disclosing â##everâ## in 1995 compared to
disclosing in the â##last 12 monthsâ## in 2005.
(ii) The help-seeking item focused on spousal â##beatingâ## in 1995 compared
to spousal â##physical abuseâ## in 2005.
(iii) The help-seeking item focused on â##getting [general] helpâ## in 1995
compared to â##get[ting] help to prevent or stop him from hurting youâ##. What
would be this type of help? Police intervention?
In my view, these two are not very comparable. The authors should separately
report analyses on this item, without forced comparison, and the discussion
should interpret the results by focussing on different aspects of help seeking
measured in 1995 and 2005.
STATISTICAL ANALYSIS
1. ** As suggested above, the comparison between 1995 and 2005 DHS surveys
for the rates of â##domestic violenceâ## needs re-operationalization.
2. ** Analysis for â##help seekingâ## should be reported separately for 1995 and
2005, without treating them as an identical measure.
3. * I assume for some analyses, there were small number of cases. Could you
report the â##coefficient of variationâ##?
RESULTS
1. ** Based on my earlier suggestion, the result section will change.
2. The authors should present the results in a more concise way. The current
version is too long.
3. Figure 1: What is â##degrees of violenceâ## on y-axis? The figure is not clear.
Could it be presented in a simple format? e.g. Pie Chart.
4. Table 4 and 2: the â##reference categoryâ## should appear in a consistent
manners (i.e. always in the 1st position or always in the last position). In the
current version, for some variables the â##reference categoryâ## is in the 1st
position (e.g. Table 2, Region) and for other variables it is at the end (e.g. Table
2, Age of respondent).
DISCUSSION
1. ** The discussion section will need revisions on re-operationalization of the
â##domestic violenceâ## and â##help seekingâ## variables.
2. An important limitation to be highlighted in the discussion section is that these
two surveys included different people. A better design would be measurement of
domestic violence in a longitudinal design.
3. * There is a need to discuss the implications for future research (e.g.
measurement issues when national surveys include different questions) and
public health programs (e.g. how to target messages for different groups).
The authors have undertaken an important work in an under researched area.
Such research is essential to advance our understanding and to address the
issue of domestic violence.
All the best in you future work!
What next?: Unable to decide on acceptance or rejection until the authors have
responded to the major compulsory revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests.