Multi-level analysis of the determinants of physical domestic violence against children using longitudinal data from MINIMat mother-child cohort in Bangladesh.

Objectives: Despite high levels of physical violence against children (VAC) globally (40-50%), the literature on the determinants of VAC remains inconclusive. Most of the literature on this topic is based on cross-sectional data, and the multi-level nature of the drivers of VAC is widely ignored. This leads to model specification problems and an inability to draw causal inferences. Moreover, despite the higher prevalence of VAC in low-and middle-income countries, studies from high income countries dominate the field. We examined the determinants of physical domestic VAC to address these gaps in the literature. Methods: Data were collected between 2001 and 2020 from 762 mother-child dyads recruited in the Maternal and Infant Nutrition Interventions in Matlab (MINIMat) study in Bangladesh. We conducted multi-level logistic regression analyses to identify the determinants of physical domestic VAC. Results: Prevalence of physical domestic violence against girls (69%) and boys (62%) was extremely high. Community-level prevalence of physical domestic VAC increased the likelihood of physical domestic VAC at the individual level across gender (girls - OR-5.66; 95% CI- 3.11-10.32; boys - OR-7.67; CI- 3.95-14.91). While physical domestic violence against mothers was not associated with physical domestic violence against girls, it reduced the likelihood of such violence against boys by 47%. Having 3 or more siblings predicted physical domestic violence against girls (OR-1.97; 95% CI- 1.01-3.81 for 3 siblings; OR-4.58; 95% CI- 2.12-9.90 for 4 or more siblings), but not against boys. While girls in Hindu families were more likely to experience this violence, the boys were not. Mother's education, employment non-governmental organization (NGO) participation and, household wealth did not predict this violence against any gender. Conclusion: We contend that physical domestic violence against mothers reflects an emphasized patriarchal culture in a family where a boy is less likely to experience physical domestic violence. Social norms and social learning theories explain the greater likelihood of a child experiencing physical domestic violence in a village with a higher level of such violence. We conclude that social norms around physical domestic VAC and patriarchal culture need to be changed to effectively address this violence.