Intimate partner violence: Causes, costs and prevention

Editor's note: This episode of VoxDevTalks is available on Spotify, Apple Podcasts, and YouTube.

Intimate partner violence (IPV) remains a pervasive human rights violation and significant global public health challenge. While the social and psychological dimensions of domestic abuse have long been studied by sociologists and public health experts, economists have only recently begun to rigorously analyse the causes, consequences, and costs of IPV.

In this episode of VoxDevTalks, Manisha Shah discusses her new review of the economic literature surrounding this critical topic. Shah, along with co-author Lydia Barsky, has synthesised findings from roughly 60 empirical papers to provide a comprehensive overview of what economic research can tell us about violence against women in low and middle-income countries (LMICs).

Defining the scope and prevalence of intimate partner violence

Shah begins by clarifying what is meant by IPV:

“So intimate partner violence, or IPV describes physical, sexual or psychological harm by a current or former intimate partner or spouse.”

To understand the economic impact of violence, one must first understand its scale. While the phenomenon is global, the prevalence rates in low and middle-income countries are alarmingly high compared to the global average.

Shah notes that globally, the statistics are stark:

"One in three ever partnered women, ages 15 to 49 will experience physical or sexual violence by an intimate partner in her lifetime."

However, these figures spike significantly in specific regions. In parts of sub-Saharan Africa, estimates reach between 45% and 50%, while in parts of South Asia, they sit between 35% and 40%. Shah also highlights that these figures likely underestimate the total burden on women, as they often exclude non-physical forms of abuse. When emotional or psychological abuse is included, the number of women reporting some form of abuse in the past year alone can rise to nearly 60%.

Furthermore, the violence begins early. Shah points out that approximately a quarter of females aged 15 to 19 report having faced violence since the age of 15. While the literature acknowledges that violence can be bi-directional - meaning women can also be perpetrators - the evidence overwhelmingly shows that men are the primary perpetrators and that women suffer far more severe consequences.

The emergence of causal economic research on IPV

Historically, economics has been late to the field of IPV research. For decades, this area was the domain of sociology, which views violence as structurally embedded in norms and institutions, and public health, which focuses on behavioural change. Economics brings a distinct perspective, grounding behaviour in individual or household preferences and constraints.

Shah explains that high-quality causal work in economics is a very recent development:

"We analyze about 60 empirical papers... and from this set of 60 or so papers, 92% of them are written from 2015 or later. And so basically, this is a empirical literature from the past 10 years."

This surge in research has been influenced significantly by other disciplines. Economists are now increasingly incorporating social norms, community dynamics, and institutional factors into their models, moving beyond simple household bargaining models to understand the complex roots of violence.

Challenges in measuring violence and improving data quality

A central challenge in studying IPV is the reliance on self-reported data. Violence occurs behind closed doors, and stigma, fear of retaliation, or social normalisation can lead to significant under-reporting. This creates a paradox for researchers: an increase in reported violence might not mean violence is rising, but rather that women feel safer talking about it.

"We may observe increases in IPV, but really that may just be because there's now reduced stigma, and we're all talking about IPV, rather than a rise in actual incidents."

Conversely, in environments where violence is deeply normalised, women may fail to perceive specific behaviours as abusive. To combat this, economists and global health organisations are moving towards 'behaviourally validated' questions. Rather than asking a woman if she has been 'abused' - a subjective term - researchers ask specific, factual questions, such as whether a partner has ever hit, slapped, or kicked them, or physically forced them to have sexual intercourse. These objective measures are crucial for generating accurate data to inform policy.

Poverty, cash transfers, and the economic drivers of abuse

One of the most robust findings in the economic literature is the strong correlation between poverty and IPV. Poverty exacerbates stress and limits investment in health and education, creating a fertile ground for conflict. Consequently, poverty alleviation tools, such as cash transfers, have become a focal point of research.

Shah notes that the evidence regarding cash transfers is generally positive. Giving money to households - whether conditionally or unconditionally - tends to either reduce violence or have a neutral effect; it rarely increases it.

However, the relationship between employment and violence is more complex. While increasing male employment generally reduces violence by easing financial stress, unemployment can trigger it through two channels: increased economic hardship and increased exposure.

This 'exposure channel' became particularly visible during the COVID-19 lockdowns, demonstrating that the mere physical proximity of partners during times of stress is a critical risk factor.

"This was the first time that males and females were forced to spend long, extended periods in the same household and were not allowed to leave. And one of the things that we learned is that women often use leaving their house as a way to cope with violence."

Social norms and the danger of male backlash

Perhaps one of the most concerning dynamics identified in recent research is the concept of 'backlash'. As development policies strive to empower women through education and financial independence, there is a risk that shifting power dynamics within the household can trigger violence.

Shah explains that when established gender hierarchies are challenged, men may resort to violence to regain a sense of authority:

"Backlash is when violence is triggered by shifts in household power... men employing IPV basically as a means of either reasserting allocative control within the household, or as an emotional response to perceived threats to his male identity or status within the household."

This is closely tied to social norms. The research indicates that in many LMICs, the acceptance of wife-beating is shockingly high among both men and women. Shah notes that female and male responses regarding the justifiability of violence are highly correlated within countries. This suggests that simply transferring resources to women without addressing the underlying symbolic threat to male status may be insufficient or even dangerous. Policies need to be designed carefully to ensure that female empowerment is not viewed as a zero-sum game where men lose out.

The global economic cost of intimate partner violence

Beyond the devastating human cost, IPV inflicts a staggering economic toll on nations. It affects labour market participation, lowers productivity, impacts children's long-term human capital, and burdens healthcare systems.

While accurate measurement is difficult due to data limitations, existing estimates paint a grim picture of the macroeconomic impact. Shah cites a study looking at nine countries to illustrate the scale of the loss:

"IPV costs each country about 1 to 2% of their GDP. This is roughly the same level as public spending on primary education in these countries."

Effective policy interventions and the role of men

If poverty causes violence, but female empowerment can trigger backlash, what is the solution? Shah argues for a multi-faceted approach. While cash transfers are effective, they are expensive. In terms of cost-effectiveness, psychosocial interventions - such as couples counselling or life skills training - show great promise.

Crucially, Shah emphasises the need to include men and boys in the solution. She details a successful intervention in East Africa that combined soccer with gender education for young men. The programme used a sport they loved as a hook to discuss consent, gender roles, and the importance of standing up for women.

"We invited their male partners to an intervention, which was, hey, come and play soccer with us once a week. But while we're playing soccer, let's also learn about things related to gender and risky behaviors, with a lot of messaging around this idea of when we stand up for the rights of girls and women, we all do better."

The results were impressive: two years later, the female partners of the men who participated reported significant reductions in IPV. This provides causal evidence that working with men to shift norms is not just an ideal, but a practical policy tool.

Looking ahead

Despite the progress, the field is young. Shah highlights a need for better theory regarding non-traditional households, more data on the long-term persistence of intervention effects, and a deeper understanding of what specifically triggers backlash.

The potential for research on this topic to have a positive impact is immense. By refining economic tools and understanding the mechanisms of violence, policymakers have the chance to improve the lives of hundreds of millions of women, children, and men, while simultaneously unlocking significant economic potential for developing nations.