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Safety and security is one of the five components of nurturing care. Safe and secure environments for families enables a caregiver to provide care for young children. While safety and security could be assessed as safety from any experiences of domestic or child abuse and neglect, including physical, psychological, and/or sexual abuse, or violence outside the home, including armed conflict, displacement, kidnapping, environmental disasters, and personal attack (WHO 2018), the literature on a caregiver’s safety and security related to child nutrition measures intimate partner violence.

Intimate partner violence is a violation of rights, a health risk by itself, and a major obstacle to a person’s ability to attain other health and nutrition outcomes and affects the ability to provide nurturing care. Experience of intimate partner violence, also called domestic violence, is assessed as experience of controlling behavior, emotional violence, sexual violence, or physical violence within a lifetime or a particular time such as during pregnancy or in the past year. Well-validated scales are based on the Conflict Tactics Scale. Using a shortened, adapted version of the Conflict Tactics Scale, which was adapted for the WHO’s multi-country study on women’s health and domestic violence, DHS and the India National Family Health Survey now assess experience of intimate partner violence across most countries. These population-based surveys make representative data available on the prevalence of domestic and other forms of violence against women within the household context. Researchers have adapted these measures by reducing the number of items. There is also a questionnaire to rapidly screen for intimate partner violence.

Ethical and safety recommendations are critical and should be in place before any research begins. WHO’s Putting women first : ethical and safety recommendations for research on domestic violence against women ( and Ethical and safety recommendations for intervention research on violence against women can be useful in preparing well.


  • Conflict Tactics Scale (5 scales)
  • DHS Domestic Violence Module: Experience of Physical and Sexual Violence by a Spouse or Partner (16 items)
  • India National Family Health Survey Domestic Violence Module (17 items)
  • Hurt, Insult, Threaten, and Scream (HITS) scale (4 items)
  • Violence Against Women Instrument (64 items)

This toolkit includes 5 measures.

Conflict Tactics Scale

BangladeshBrazilNepal 80 items

The Conflict Tactics Scale (Straus 1979, 1990) measures the extent to which partners in a relationship engage in concrete acts and events of psychological, physical, or sexual attacks on each other; the consequences of the attacks; and partners’ use of reasoning or negotiation to deal with conflicts.

DHS Domestic Violence Module: Experience of Physical and Sexual Violence by Partner or Spouse

BangladeshEgyptHondurasKenyaMalawiRwandaEthiopiaLiberiaTanzaniaBoliviaBurkina FasoCambodiaCameroonColombiaGabonGhanaHaitiIndiaMaliMozambiqueNepalNigeriaPeruRepublic of MoldovaSao Tome e PrincipeTimor L’EsteUgandaTanzaniaZambiaZimbabwe 16 items

A module included in the Demographic and Health Survey (DHS), a large-scale nationally representative survey that covers many aspects of family and health for both men and women, in addition to domestic violence.

India National Family Health Survey: Domestic Violence Module

India 17 items

The Domestic Violence Module in the India National Family Health survey measures women’s experience of physical, sexual, and emotional violence. It also asks about physical consequences of violence.

Hurt, Insult, Threaten, And Scream (HITS) Scale

Ethiopia 4 items

A screening tool increasingly used in clinical practice to assess intimate partner violence (IPV).

World Health Organization’s Violence Against Women Instrument (VAWI)

Togo 64 items

An instrument to study women’s exposure to emotional, physical, and sexual violence by an intimate partner. It is part of WHO’s Multi-Country Study on Women’s Health and Domestic Violence against Women conducted in 10 countries.