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Atreyee Sinha and Aparajita Chattopadhyay

increased risks of premature births, low birth weight, neonatal and infant mortality, and maternal
mortality (Hossain and Hoque, 2005; Nigussie Mariam and Mitike, 2004).
In India, 35% ever married Indian women aged 15–49 years reported to have experienced domes-
tic violence in various forms in the hands of their intimate partners (IIPS and Macro International,
2007) and this depicts the poor condition of women even within families. The presence of violence
within intimate relationships like marriage, leaves women in extremely powerless condition, lacking
the ability to take decisions. This may in turn reduce proper utilization of health care services by
them. Therefore, studying the association of spousal violence and health care utilization calls for
special attention. The present paper aims to examine how the level of maternal and child health
(MCH) care utilization differs in North and South Indian states by experience of spousal violence
and to what extent the experience of spousal violence plays a role in determining the utilization of
full ANC and institutional delivery for young married women.
The rationale behind looking into North and South India separately is the prevailing cultural and
social heterogeneity. Cultural norms and behaviours in India are diverse; extent of patriarchy is also
varied and is directed by regionally prescribed social systems. The Southern part of the country al-
lows women to have more exposure to the outside world, more voice in family life, and more free-
dom of movement than that of the North (Jejeebhoy, 2000; Jejeebhoy and Sathar, 2001). These pre-
vailing societal norms and beliefs account for low status and esteem of women within the family, in
the society and even to the self. This stratified gender relations in the Northern society has come out
to be more narrow in acknowledging women’s values and their decision making power, constraining
their every move and access to resources and conferring them the status of a mere product in the tra-
ditional dowry market (Dyson and Moore, 1983; Jejeebhoy and Sathar, 2001; Jejeebhoy, 2002). The
ideology of male supremacy legitimises the use of force as the vehicle to display the male power
over them (Jewkes, 2002) and the violent turn up of an intimate relation, as mentioned by many au-
thors, is an extension of the belief that men have an eternal right to control women’s behaviour (Vi-
saria, 2008; Campbell, Webster, Koziol-Mclain et al., 2003; Monemi, Pena, Ellsberg et al., 2003;
Parish, Wang, Lauman et al., 2004).
In addition to the cultural differences, the well documented North-South divide also exists on
various development indices and this has been prevailing in the country consistently over a long pe-
riod of time (Dyson and Moore, 1983). It is argued that there exists a considerable gender disparity
in terms of life expectancy at birth, various health outcomes like maternal and child mortality, fe-
male literacy and female work participation where South Indian states perform better; this in turn
depicts a distinct regional imbalance in terms of women’s position in the family and their vulnerabil-
ity (Dyson and Moore, 1983). Powerlessness among women is more acute in North India (Karve,
1965). Women in the North have relatively lower autonomy, freedom of movement, exposure to the
outside world, control over material and economic resources, and property inheritance rights than the
women in the South especially after marriage (Jejeebhoy and Sathar, 2001). As gender equity
is closely associated with the use of health care services, it is assumed that, in the North Indian states,
the level of maternal and child health care utilization will be lower and the effect of spousal violence
on MCH care utilization will be stronger in comparison to the South Indian states.

2. Data and Methods

2.1 Study Sample
We used data from the third round of Indian Demographic Health Survey (DHS) known as National
Family Health Survey — NFHS-3, 2005–2006. A sample of currently married women, aged 15–30
years from few Indian states, selected on the basis of high incidence of spousal violence, was consi-
dered for analysis. The first group of selected states were Bihar, Madhya Pradesh, Rajasthan, and
Uttar Pradesh with 60.8%, 49.1%, 50.2%, and 45.0% ever married women experiencing spousal vi-

International Journal of Population Studies | 2016, Volume 2, Issue 2 109