Testing the Woman Abuse Screening Tool to Identify Intimate Partner Violence in Indonesia

Intimate Partner Violence (IPV) is a global public health problem. IPV prevalence in Indonesia has been estimated to be less than 1%, based on reported cases. It is likely that IPV prevalence is underreported in Indonesia, as it is in many other countries. Screening for IPV has been found to increase IPV identification, but no screening tools are in use in Indonesia. 

The aim of this study was to test the translated Woman Abuse Screening Tool (WAST) for detecting IPV in Indonesia. The WAST was tested against a diagnostic interview by a trained psychologist on 240 women attending two Primary Health Centers in Jakarta. IPV prevalence and the reliability, sensitivity, and specificity of the WAST were estimated. 

Prevalence of IPV by diagnostic interview was 36.3%, much higher than published estimates. The most common forms of IPV identified were psychological (85%) and physical abuse (24%). Internal reliability of the WAST was high (α = .801). 

A WAST score of 13 (out of 24) is the recommended cutoff for identifying IPV, but only 17% of the Indonesian sample scored 13 or higher. Test sensitivity of the WAST with a cutoff score of 13 was only 41.9%, with a specificity of 96.8%. With a cutoff score of 10, the sensitivity improved to 84.9%, while the specificity decreased to 61.0%. 

Use of the WAST with a cutoff score of 10 provides good sensitivity and reasonable specificity and would provide a much-needed screening tool for use in Indonesia. Although a lower cutoff would yield a greater proportion of false positives, most of the true cases would be identified, increasing the possibility that women experiencing abuse would receive needed assistance.

IPV Help-Seeking Behavior (N = 240).

Would report IPV
Would visit a PHC	26 (10.8%)
Would visit an Emergency Response Unit	3 (1.3%)
Would visit to service provider	20 (8.3%)
Would report to a policewoman’s desk	24 (10.0%)
Would call a hotline service	3 (1.3%)
Would report, but did not specify to whom	7 (2.9%)
Total	83 (34.6%)
Would not report
Would talk to family and friends	106 (44.2%)
Would remain quiet	32 (13.3%)
Would leave husband	4 (1.7%)
Would practice self defense	6 (2.5%)
Total	148 (61.7%)
Did not respond to question	9 (3.7%)

Note. IPV = Intimate Partner Violence; PHC = Primary Health Centers.

Full article at:   http://goo.gl/GDrHkM

By:  Livia Iskandar, MSc, DrPH,¹ Kathryn L. Braun, DrPH,¹ and Alan R. Katz, MD, MPH¹

¹University of Hawaii, Honolulu, USA

Corresponding Author: Kathryn L. Braun, Office of Public Health Studies, John A. Burns School of Medicine, University of Hawaii, 1960 East-West Road, Biomed D-204, Honolulu, HI 96822, USA. Email: ude.iiawah@nuarbk

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