Mental health counselling for abused women Careful attention was given to a number of ethical concerns in this study. Consent from women was sought at the end of the counselling session for go- ing back to them, which allowed this evaluation to take place. Standard informed consent procedures were followed before the in-depth and survey inter- views. At the start of all interviews, the participants were informed orally of the purpose and nature of the study and its potential benefits. Because of the low levels of literacy, verbal consent was requested. As part of the consent procedure, the participants were informed that the data collected would be held in strict confidence. To ensure that the par- ticipant was aware that the survey included ques- tions on highly-personal and sensitive topics, the interviewer forewarned the participant that some topics would be difficult to talk about. It was made clear to the woman that participation in the study was voluntary, and even if she agreed to participate in the study, she would be free to terminate the in- terview at any point and to skip any questions that she did not wish to respond to. The following special measures were adopted to en- sure that the study did not jeopardize the safety of the interviewees or the interviewers: The place of interview was chosen according to the convenience of the study participants. The inter- views were carried out in private, and only very young children, aged less than two years, were per- mitted to be present. Interviewers were trained to terminate or change the sensitive topic for dealing with interruptions. The training included a num- ber of role-play exercises simulating different situa- tions that may arise in the field. Each data collector carried a dummy questionnaire which excluded the sensitive questions. They were for use in case people outside the study insisted on reading the questionnaire, The principle of doing no harm and respecting a person’s decisions and choices was followed. The data collectors were trained to ask questions sensi- tively, in a supportive and non-judgemental man- ner. The importance of confidentiality was empha- sized in the training. The questionnaire, tapes, and transcripts did not include any real names or ad- dresses. Only the researchers had access to the data and used these exclusively for the purpose of re- search. The ethical review committees of ICDDR,B and Uppsala University approved the study. RESULTS Background characteristics of women surveyed Background characteristics of the 372 abused Volume 27 | Number 4 | August 2009 Naved RT et al. women surveyed for programme-evaluation purpose are presented in Table 2. About 35% of the women in the sample were aged 30 years or more while 12% were aged less than 20 years. About 41% had no education, and only 1% had post-secondary level of education. About 29% came from the poor, 30% from below middle class, 22% from middle class, and the remain- ing from upper-middle class and the rich. About 15% had been exposed to physical, 36% to sex- ual, and 65% to emotional violence in their life- time. The median SRQ score for all the pregnant women included the MINIMat study was 5. In this study sample, the score was 8 for ever emo- tionally-abused women, 7 for ever physically- abused women, and 7 for ever sexually-abused women. About 28% of the study women report- ed suicidal ideation during the last four weeks. Table 2. Background characteristics of women surveyed (n=372) Characteristic of surveyed woman Percentage 11.9 23.7 29.1 35.3 40.8 28.2 30.3 0.8 29.0 29.5 21.7 9.4 10.5 15.3 36.0 5 8 7 7 28 481 Age (years) <20 20-24 25-29 30+ Education in completed year No Primary Secondary Post-secondary Socioeconomic status* Poor Below middle class Middle class Upper-middle class Rich Exposed to lifetime physical violence Exposed to lifetime sexual violence Median mental stress score by expo- sure to violence† No violence based on larger dataset Emotional violence Physical violence Sexual violence Suicidal ideation *Socioeconomic status defined by the wealth index based on principal component analysis of assets owned by households; †Distress score was calculated based on responses to the self- reported questionnaire—20 used in screening for mental distress