Shadow Pandemic: IPV Experiences of Female Domestic Workers in Karachi, Pakistan during the COVID-19 Lockdown.

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Bhavita Kumari, Mai Do, Aubrey Spriggs Madkour, Janna Wisniewski This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8479706/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The ‘shadow pandemic’ of gender-based violence escalated parallel with the COVID-19 pandemic. This study explored how COVID-19 lockdowns may have impacted women’s empowerment and IPV patterns and the role of social support among female domestic workers (FDWs) in Pakistan. Methods: Exploratory qualitative research with in-depth interviews was conducted, based on Connell’s Theory of Gender and Power. Married FDWs were recruited by snowballing (n=40). Themes were identified for patterns and factors associated with IPV. Data were analyzed using Maxqda by conducting thematic coding. Results: Most FDWs in the sample lost jobs during lockdown; or paid partially. Conflicts increased in the family, primarily due to financial constraints. Loss of financial resources were more likely to experience IPV than participants without any economic loss. Most participants resorted to prayers and patience. Almost all were reluctant to seek help from police; nearly no one had information or access to organizations that support women in similar situations. Conclusion: It is crucial to understand the processes of changing marital power dynamics during crises to mitigate the ‘shadow pandemic’ of violence against women. The study informs policies to regulate the labor industry, especially during crises situations. Gender Studies Women's studies IPV Pakistan women’s empowerment Covid-19 lockdowns Figures Figure 1 Key Message The study is suggestive of ‘situational violence’ related to economic hardships, rather than ‘intimate terrorism.’ Recommendation for legal aid, regulation of labor laws to provide paid leaves to women in low-paid jobs, and alternative employment opportunities for women in times of crises. Surveys should explore the effectiveness of help seeking behaviors the women employed during the pandemic. Introduction The World Health Organization (WHO) declared the COVID-19 outbreak as a pandemic on March 11th, 2020, ( 1 ) The government of Pakistan imposed a nationwide lockdown on March 24th, 2020, ( 2 ), and extended it twice until May 9th, 2020 ( 3 , 4 ), when the lockdown was eased gradually in phases ( 5 ). The silent pandemic of gender-based violence (GBV) that escalated parallel to the COVID-19 pandemic is also called the ‘shadow pandemic’ due to the inadequate acknowledgment given to the issue ( 6 , 7 ); most countries reported a 25–35% increase in domestic violence reports in the first month of their lockdowns ( 8 ) PUCAR-15, the police helpline in the socio-economically similar neighboring province of Punjab, reported a 25% surge in reported cases of GBV during the strict lockdown period (March 23rd to April 23rd, 2020), and a decrease of 10% once the strict lockdown was relaxed to a partial lockdown in May 2020 ( 9 ). Considering the global situation and reports from the neighboring province, a 25–30% surge in intimate partner violence (IPV) seems likely to have occurred in Karachi. Three-fourths of informal workers across the globe have been hit by lockdowns due to the COVID-19 pandemic, mainly in urban areas ( 10 ) women being a considerable proportion of the affected informal sectors ( 10 ). The Pakistani Bureau of Statistics reports that 72% of the labor force participates in the informal sector and estimated 8.5 million domestic workers in Pakistan ( 10 , 11 ). Being a metropolis, Karachi attracts migrants from other parts of the country for employment and a better livelihood. Hence, FDWs are an integral part of the informal sector in Karachi. FDWs, Because of COVID-19, most of them could not work during the lockdown ( 12 ). Hence, these women were likely to spend more time at home, unemployed, with heightened stress, and with their husbands than in normal circumstances. There is a need to better understand IPV experiences among vulnerable populations like FDWs in Pakistan and the processes of empowerment that can exacerbate or mitigate such incidents during the COVID-19 lockdown. Most studies exploring the relationship between COVID-19 and IPV have employed either record-based data or internet-based surveys ( 13 , 14 ). However, there remains a gap in understanding the processes and nuanced IPV experiences for women during the pandemic lockdown. This study aims to fill the gap that how concepts of empowerment and IPV operationalize among domestic workers. Conceptual Framework The conceptual framework is based on Connell’s Theory of Gender and Power, which was operationalized by Wingood and DiClemente ( 15 ). Figure 1 presents the domains of women’s empowerment and how we hypothesize them to relate to IPV experiences during the lockdown. The existing literature suggests that some intimate relationships depict power imbalance and control leading to severe or chronic IPV of all types, including verbal, physical, and sexual violence ( 16 ). However, some couples exhibit situational or acute violence, which is often less severe than intimate terrorism and infrequent ( 17 ), and often associated with catastrophes and conflict ( 18 ). Hence, it may be suggested that the socio-economic crisis caused by the COVID-19 pandemic and preventive measures puts vulnerable women at an increased risk of IPV, as explained in Fig. 1. It presents how women’s empowerment relates to IPV during the COVID-19 lockdown. COVID-19 has caused multidimensional stressors, including loss of employment and financial instability( 19 ) Economic insecurity can lead to negative coping strategies including substance abuse ( 20 ), and stress, triggering violent behavior among potential perpetrators ( 21 ). Increased physical confinement with a potentially violent spouse due to movement restrictions can increase exposure to a potential perpetrator( 22 ) Partners who might not be violent in normal times are also likely to feel more stressed due to a lack of social networking (Peterman, 2020). Such potential perpetrators may perceive violence as a coping mechanism to the perceived loss of control, triggering situational IPV or aggravating chronic violence ( 19 ). When men faced financial stress and helplessness, they endeavored to exercise their power and used violence against women to gain a sense of control( 23 ) The goal of this research is to investigate FDWs’ experiences and perceptions of IPV, women’s empowerment, social support, and their relationships during the 2020 COVID-19 lockdown from the perspective of FDWs. This exploratory research was designed to understand how COVID-19 restrictions and related factors may have influenced IPV experiences among FDWs in Karachi, Pakistan, and the role of social support in modifying IPV experiences. Methods An exploratory qualitative study was conducted to understand the COVID-19 pandemic’s short-term impact on IPV experiences among FDWs in Karachi through in-depth interviews. A prevalence study in Karachi in 2011 reported that around 84% of women faced at least psychological violence during their lifetime ( 24 ) Hence, it was assumed that more than 80% of recruited women would have ever experienced IPV. Interviews were conducted until ‘theoretical-saturation’ was achieved. Data were analyzed simultaneously with the interviews being conducted; when no new information was obtained, ‘saturation’ was achieved, data collection was stopped. Using snowball sampling 45 FDWs were approached face-to-face for the interview. Five women refused due to time constraints; 45 were interviewed for this study. Each woman was interviewed once for 30–40 minutes at a place most convenient for women to minimize the disruption to their daily life and ensuring privacy. An interview guide was developed based on Connell’s Theory of Gender and Power and the conceptual framework presented above. The semi-structured interview guide included questions on: a) COVID-19 lockdown-related experiences, including husband’s and wife’s employment status, financial resources, and physical confinement status, b) women’s empowerment, including their perception of different domains of empowerment and how it may have changed due to the pandemic and restrictions, and c) attitudes toward IPV, IPV experiences and patterns, if any, and how it may have changed due to the pandemic and restrictions. Fieldwork began after obtaining IRB approval from Tulane University, USA (SPHTM 2020 − 1868), and Jinnah Sindh Medical University, Pakistan (JSMU/IRB/2021/-404). The interview guide was validated for translation by an independent linguistic expert and pilot tested. Informed consent was taken verbally after explaining the research objectives. In-depth interviews were conducted by BK. The audio-recorded interviews were transcribed and analyzed along with field notes using Maxqda in Urdu ( 25 ). Thematic analysis was conducted ( 26 ), and response patterns within the data were identified in two ways: an initial codebook was developed based on the theoretically informed concepts and the interview guide in a ‘deductive’ or ‘top-down’ approach. Coding was further conducted by BK by coding interview transcripts line-by-line, building upon the codebook. Next, axial coding was conducted using the revised codebook, whereby these codes were merged into themes through discussion. This way major themes were identified, in an ‘inductive’ or ‘bottom-up’ approach, for the patterns and factors associated with IPV in a lockdown. The thematic analysis was conducted following the six-step guide ( 26 ); moving forward and back between the following steps: i) familiarizing with the data, ii) generating initial codes, iii) searching for themes, iv) reviewing themes, v) defining names, and vi) producing the report. Once preliminary findings were reached, member checking was conducted to explore the credibility of results to ‘check for accuracy and resonance with their experiences’ ( 27 ); the six ’seed’ participants were contacted to verify the interpretation of their interviews. Verbatim quotes were compiled and translated into English for use in publications and research dissemination. Public Involvement Patients or the public were not involved in the design, conduct, reporting, or dissemination plans of this research. The study was developed by the research team based on existing literature and identified gaps in understanding the experiences of partner violence among domestic workers. Results The mean age of the participants and their husbands’ age was 34.4 and 39.8 years old, respectively. Most of the participants lived in joint households but no participants owned the houses they lived in; Most participants reported having a mobile phone in the household; only six had a plain personal mobile phone. One participant mentioned that women in her community were not allowed to keep a phone. Women were asked about media exposure because media was the primary source of dissemination of information during the lockdown. Fifteen participants had a television; others reported watching at their employers’ or neighbors’ houses. The women worked at various homes every day, working for 6-8 hours every day on average. The average monthly earnings of the women were PKR 12,040 ($70), ranging from PKR 4,000 ($23) to PKR 25,000 ($144). Most husbands earned more than their wives; their average monthly earnings were PKR 15,833 ($90), ranging from PKR 8,000 ($45) to PKR 30,000 ($171). However, ten husbands had no earnings long before the pandemic due to old age or sickness; women being either sole breadwinners, or their sons contributing.. Overall, the average monthly household earnings were PKR 33,719 ($193), ranging from PKR 20,000 ($114) to PKR 72,000 ($411), compared to the average monthly household earnings of Urban Sindh, that is, PKR 49902 ($285) (Pakistan Bureau of Statistics, 2019). Thematic Analysis Findings The four main themes identified were perceived changes during the COVID-19 lockdown in 1) patterns of IPV experiences, 2) factor’s influencing IPV experiences, and 3) social support. Theme 1: Patterns of IPV Experiences during COVID-19 lockdown The narratives from the interviews revealed differences in patterns of IPV experiences of women before the pandemic and during the COVID-19 lockdown. Most women (60% or n=24) in this study had experienced violence at least once from their husbands in their lifetime. Two-thirds of these women reported experiencing frequent IPV in the recent years before the pandemic (n=16), while a third of the women did experience IPV during their early years of marriage, but there was none in the last 6-10 years (n=8). Most women who had been experiencing IPV in the recent years before the pandemic reported increased conflicts during the COVID-19 lockdown; thirteen women faced increased frequencies of IPV. Also, three out of the eight women, who had not experienced IPV in the last 6-10 years, now experienced violence during the lockdown. Even among the sixteen women who had never experienced IPV prior to the pandemic, nine of them experienced violence during the lockdown. My husband was fine previously. Now he gets angry with me and the kids. He beats up the kids. (FDW8) Yes, (violence was) happening too much. (His) anger had increased, on me and on the kids. (He) used to curse more. Once he beat me too. (FDW11) For most women, violence, especially psychological, was a normalized phenomenon. Often, they could not distinguish between marital conflicts and verbal abuse, leading to a greater tolerance towards psychological violence. Almost every woman who experienced IPV during COVID-19 lockdown reported increased verbal abuse. Twelve women reported increased physical abuse, some to the extent of husbands beating the kids during the lockdown (n=4). Yes, (we were) at home all the time, so there was more stress and more quarrels. (FDW6) Theme 2: Factors influencing IPV experiences during COVID-19 Lockdown The study identified the major factors that influenced IPV experiences during COVID-19 lockdown. The identified factors contributed to women’s empowerment according to Theory of Gender and Power, as described below: Household wealth and Financial Independence Most women felt that they could not make their ends meet during the lockdown; fifteen women did not get paid anything during the lockdown, and some of the employers either fully or partially paid another fourteen. On the other hand, twelve women were given paid leaves from all their employers. Some women reported receiving cash or grocery as charity or zakat [1] from their employers or other philanthropists (n=7). No, there was no work, so who will give the money (FDW9) One baaji [2] sent me complete salary and grocery for two months. (FDW1) As mentioned above, ten husbands had not had any earnings for a long time, even before the pandemic. Among the rest, half were unpaid (n=15), and the rest were paid partially or fully during the COVID-19 lockdown. Some of the husbands with government jobs were paid regularly (n=5), while daily wagers were comparatively more financially constrained (n=11). My husband used to get meals too from his employers. (FDW7) He does not have a (fixed) salary. (He) just works as a daily wager. He did not get anything (in the lockdown). (FDW8) My husband had a property (real estate) business. It went into loss. (FDW33) During the COVID-19 lockdown, some families had to take loans from their employers to cover expenses (n=6). Generally, participants reported their female employers ( baajis ) as their primary financial support. Some participants received assistance from the government (n=4), while two women complained of not being able to receive the assistance and were seeking help regarding the process. It had become difficult to arrange household expenses and groceries. Sometimes we cooked just lentils and sometimes potatoes for meals. (FDW2) Just like that, sometimes we would just eat green chilies, sometimes something else. It was extremely hard. I did not get paid anything from my baajis. There was nothing to eat. Children were starving too. Sometimes we would just borrow or do something else to make it. May God keep it well now. (FDW13) Now kids are starving for two, three days. We will die this way. Ma’am, I am working for the kids. My loan needs to be paid off. The rent is overdue. He insults us. The landlord humiliates us. Even now, three months’ rent is unpaid. I cannot sleep at night. Keep thinking about how we will manage the household; how we will make a living. We cannot even make expenses for one day... 24-25 thousand (rent). Where do I get that? (FDW27) Most women perceived financial constraints and joblessness to be the major factor contributing to their IPV experiences during COVID-19 lockdown. Often, women believed that their husbands’ stress about arranging meals for the family during the lockdown led them to be violent at home (n=12). There is tension, and trivial disputes keep happening. Obviously, there was income, and now there is none. When we are jobless and expenses are not met, there are fights. (FDW24) Yes, (violence was) happening too much. Obviously, (he) did not get the money, so (his) anger had increased, on the kids and on me. (He) used to curse more. When one does not have anything to eat and no job either, anger will increase. Once, he beat me too. (FDW11) Among the fifteen participants who had no earnings during the COVID-19 lockdown, twelve experienced violence during the same period. A participant, who did not receive a salary during the lockdown, perceived financial constraints to be the reason for their IPV experience. My husband used to support me a lot, but when there are issues, and there is no work, then there are problems. Obviously, when there is nothing to eat, there are problems. (FDW33) Eight out of the fourteen women who had partial loss of income, and five out of eleven women who were paid fully, experienced some violence during the lockdown. A participant who continued to work for one employer, but not for the others (partially working), did not report any violent experiences. No, there were no quarrels. When we have (something to eat), we eat together. When we do not, we all just sit. (FDW32) Among the fifteen participants whose husbands had no earnings during the COVID-19 lockdown, ten experienced some violence during the same period. Even three out of the ten husbands who had not been working before the pandemic were violent towards their wives. Husbands with no income had an increased tendency for violence at home, as said by a participant: Yes, (the violence was) happening too much. Obviously, (he) did not get the money, so (his) anger had increased on the kids and me. (He) used to curse more. Anger will obviously grow when one does not have any food or a job. Once, he beat me too. (FDW11) Five out of eight women whose husbands had partial loss of income, and four out of seven women whose husbands were paid fully experienced some violence during the lockdown. A participant, whose husband was a government employee and was paid during the lockdown, did not report any violence. No, he was not violent toward me. (FDW2) Workforce participation The majority of the FDWs were told by their employers not to come to work during the COVID-19 lockdown (n=27); however, the duration of being out of work varied and was not consistent with the official lockdown period. Most women stayed home for an average period of two months. Two women stayed out of work for 4-6 months. However, the earnings did not correlate with their work hours, as some were paid regardless of their working time. Employers told us not to come for a few months. They said they did not have money and they would do their chores themselves. They told us not to come to work for three months. They called us for work after three months, then started paying us. (FDW39) Nine FDWs continued working for some employers during the COVID-19 lockdown, whereas some of their other employers told them not to come to work; only four women continued to work fully during the lockdown. Two women had shorter work hours and would hastily finish their tasks because of employers’ fears of contracting COVID-19. Baajis would sometimes call me for work and sometimes give me an off. (FDW23) Five out of the nine women who worked partially, and two out of four women who worked during the lockdown, experienced some violence during the same period. A woman who went to work during the lockdown did not experience IPV. Among the twenty-seven participants who did not work during the COVID-19 lockdown, eighteen experienced violence during the same period. One participant who did not work during the lockdown perceived increased violence due to physical confinement with the perpetrator. Yes, we were home all day, so there was more stress, fights, and quarrels. (FDW6) PHYSICAL Confinement Most women were confined at home with their usual family members, primarily due to enforced lockdown and the unavailability of public transport. A few (n=4) women believed staying together in the same house all the time increased conflicts and violence at home. If the environment at home is unpleasant and stressful, you start despising each other’s faces. (We) could not go out either. What can one do then except getting angry? (FDW22) Yes, when (we) are sitting idle, it happens. Quarrels, conflicts, fights, etc. (FDW21) Household decision-making Prior to the pandemic, the eldest male member of the household, like the husband in a nuclear family or father-in-law in a joint family, was usually the primary decision-maker. Some women participated in the decision-making along with their husbands (n=7). The same continued to be valid during the lockdown. However, one woman perceived that men were wrong to interfere if the women were the breadwinners, especially in financial constraints, like during the lockdown. Women faced the most problems. They had to see her house and also work outside. There are no jobs. They had to fulfill (the expenses) with less money. When the men are at home, there are more expenses. When they keep grumbling, you lose your mind. They would not bring anything (money) but ask us. What will we give you? Have you given me some money (to save), so we could give you it back? (FDW20) Access to healthcare Almost no woman visited any healthcare facility during the lockdown. The most common reason for not having access to healthcare during the lockdown included lack of money or transport, resorting to self-medication. However, some women avoided visiting a healthcare facility since the COVID-19 lockdown due to fears of contracting the virus (n=7). No, I did not go to the hospital. I was scared due to Corona. (FDW6) - We did not need to (go to a hospital) during the lockdown. We took so much care that there was no need. (FDW7) Baaji helped me. She gave me three medicines, and I took Panadol for fever. Also, I took care and drank herbal teas. Then I got better. (FDW8) Sexual negotiation Our sample participants had mixed experiences about the ability to negotiate sexual intercourse. While half of the women did not state that their husbands were coercive about sexual intercourse and thought that their wish and wellness were respected, the other half perceived their husbands’ to be coercive about sexual intercourse, which continued during the COVID-19 lockdown. Attitudes toward IPV The women who experienced IPV during the COVID-19 lockdown tried to justify their husbands’ actions; they tended to accept IPV as a justified consequence of financial constraints during the lockdown period (n=12). When one does not get any food or job, obviously (husband’s) anger will rise. (FDW12) Yes, (he beats) when he gets into tension or when he is worried about money, like in the lockdown (FDW17) No, my husband is genuinely nice. But when two people are constantly at home, and there is tension, so obviously, (he) will get somewhat angry. (FDW24) Theme 3: Social Support during COVID-19 lockdown The study identified the key social support in the women’s lives during the COVID-19 lockdown. The most common source of social support identified by 14 women during the COVID-19 lockdown came from their baajis or their female employers. These women were financially supported by their employers, either by paid holidays or being aided by charity or zakat during the COVID-19 lockdown. The second crucial social support theme identified in these interviews was a reaffirmation of their belief in God. Eleven women restated their trust in Allah to solve their challenges, be it their financial constraints, pandemic fears, or marital relations. We ask Allah and then request our baajis. (FDW11) God is the one who does everything. Bhabhi (employer) used to send the grocery and salary. Once, I sent my father to bring the salary. She also paid my child’s (school) fees. (FDW26) Generally, women with fully paid salaries or financial aid likely reported more financial stability and, in most cases, their home environment to be peaceful. We would just stay at home depressed. Whatever was cooked, we would just eat gratefully. (FDW1) As described earlier, most women normalized IPV and considered it as a way for men to release stress during a period of financial constraints. Some women resorted to patience and prayers, with little support or options for help (n=3). I would cry out praying to Allah. Who else helps? (FDW3) Most women in our sample did not have close relatives in Karachi, as they had migrated from various villages in Pakistan for employment. A common experience was not being able to visit with their relatives due to strict lockdown (n=11). Some women perceived the lockdown period to be lonely without any social support (n=4). Yes, relatives used to come, but since Corona, the guards do not let guests inside the society. (FDW2). Three women left Karachi for the lockdown period to stay with relatives in their villages or hometowns. The reasons given by these women were either to cut down living expenses in the city or to evade the violent behaviors of their husbands. He became annoyed. He showed more anger. I took my kids and went to my aunty. I went to Punjab. (He) used to say it is expensive. What will we eat? How will we live? I had a child (delivery). He was one month old, that is why he sent me to Punjab. (FDW9) Discussion Pakistan has a prevalence of approximately 30% reported lifetime IPV among ever-married women; however, more than half of these women do not seek help ( 29 ) This empirical study examined the IPV patterns and the factors that influence IPV experiences during the COVID-19 associated lockdown in Karachi, Pakistan. Research increasingly highlights that a dyadic characteristics, such as their fertility preferences, spousal age differences, and bargaining powers, play a critical role in determining women's health ( 30 , 31 ). The silent pandemic of GBV or ‘shadow pandemic’ escalated parallel with the COVID-19 pandemic ( 8 ). It is imperative to understand the IPV experiences among vulnerable populations and the processes which influence these experiences during crises like the COVID-19 pandemic, which has caused a widespread lockdown and financial constraints. This research aimed to investigate FDWs’ experiences and perceptions of IPV, women’s empowerment, social support, and their relationships during the first COVID-19 lockdown in 2020 from the perspective of FDWs. Specifically, the focus was on patterns of IPV experiences and influences of potential changes in women’s empowerment on IPV experiences among the FDWs in Karachi, Pakistan. The first theme described patterns of IPV experiences among FDWs in Karachi during the COVID-19 lockdown, including: i) increases in IPV experiences, especially among women who had not been experiencing IPV pre-pandemic, and ii) patterns of increased emotional and psychological abuse and conflicts, along with physical violence. The findings are consistent with the Sustainable Social Development Organization’s report of an increase of 200% in IPV in Pakistan during COVID-19 ( 32 ). Other studies in Pakistan also reported similar patterns of emotional abuse, like ‘constant criticism, intimidation, and disapproval of daily chores (Ali & Khalid, 2021). However, most reports focusing on all types of GBV, rather than IPV specifically, during the COVID-19 lockdown in Pakistan, reported physical abuse or more severe crimes, based primarily on police data and media reports ( 33 , 34 ) The second theme described factors and processes, contributing to women’s empowerment, that influenced IPV experiences among FDWs in Karachi during the COVID-19 lockdown, including: i) financial constraints including overall decreased household income leading to stress about arranging household expenses, ii) ) most women not being able to work, or working only part of the time or shorter hours, iii) physical confinement with usual family members due to strict lockdown enforced by law agencies or the unavailability of public transport, and iv) tolerance of husband’s violent behavior on the pretext of financial stress. Similar to this study’s findings, the limited literature has suggested financial stress and physical confinement to be direct causes of increases in IPV during the pandemic. A letter to the editor reported a rise in emotional violence in Bangladesh among married women; the probable reason was increased frustrations among male family members due to financial stress and inadequate social opportunities(Sifat, 2020). Also, news blogs suggest that most women, regardless of their working status, were confined with their families at home during the lockdown, having no escape from the perpetrator ( 32 , 36 ) The theme also identified the influence of changes in women’s empowerment on IPV experiences among FDWs in Karachi during the COVID-19 lockdown, including: i) increased IPV experiences among women who had no earnings during the lockdown, and ii) husbands without financial resources being more violent at home. Similar to this study’s findings, other authors have associated domestic violence during the pandemic to wife’s unemployment and household financial stress, lack of social support, and movement restrictions (Ali & Khalid, 2021; Vora, 2020). The UN Human Rights report indicated that the pandemic and its associated issues, like financial crises, and restricted movement, had transformed home into an intimidating place for women( 38 ). A final theme described the perceived changes in their social support and how these changes influenced IPV experiences among FDWs in Karachi during the COVID-19 lockdown, including: i) primary support system during the lockdown being their employers or baajis , ii) firm religious faith and hope that God will improve their life someday, and iii) leaving the city to be with other family and away from the perpetrator. The findings are important as when women do not have an alternative support system, the tendency to report IPV is often extremely low ( 39 ) Our study findings shed light on understanding the implications of the government’s COVID-19 restrictions and help explore innovative solutions to mitigate IPV incidents and make these resources accessible on multiple platforms to maximize reach ( 40 ) The government’s ‘Stay Home, Stay Safe’ campaign may have inadvertently compelled women to spend more time with potential perpetrators ( 41 ). In addition, the shift of economic autonomy and dependency of these women in informal economies made them vulnerable to exploitation and violence ( 42 ) Law enforcing personnel should be trained to empathize and understand that home could become an unsafe environment during the lockdown, and IPV victims might need to be evacuated. Several measures the Pakistani government took to tackle GBV during the lockdown were deemed insufficient and symbolic, such as multiple helpline numbers ( 33 ). Similarly, there were no significant contributions of civil society to mitigating GBV ( 33 ). There was an acknowledgment of increases in GBV incidents by the government; however, there has not been an organized reporting system for GBV cases ( 39 ) The study is suggestive of ‘situational violence’ related to economic hardships rather than ‘intimate terrorism’; often, help-seeking behaviors of victims were not common in these cases ( 43 ). Therefore, the increased IPV incidence during the pandemic warrants enhanced measures to distribute resources and make them more accessible to vulnerable groups. Furthermore, the study suggests that while all women did not experience IPV, the children were subjected to violence. The incidental finding suggests exploring the impact of COVID-19 lockdown on violence against children. The study has identified the lack of economic empowerment, financial constraints, and physical confinements to be associated with increased IPV experiences during the pandemic. At the same time, social support was found to be an alleviating factor. These findings suggest that the government of Pakistan could arrange for legal aid and alternative employment opportunities for women during crises. Also, labor laws should be regulated, so women involved in low-paid jobs could avail paid leaves in times of crisis. During a pandemic, access to phones, media, and the internet, which is often limited, may become more constrained. Help-seeking becomes more challenging when victims are confined with potential perpetrators. Hence, engaging the community groups identified as social support, like the employers and religious leaders, may help bridge the gap between the victim and GBV-focused initiatives; they can play a crucial role in advocacy, improving access as well as building trust for the GBV services. Secondly, media could play a vital role in disseminating information and advocacy through commercials, drama, and documentaries of survivors and empowered women. Hence, a multi-dimensional approach focused on advocacy, empowerment, and support may build confidence in women to seek help. To our knowledge, this is the first empirical study exploring the impact of COVID-19 restrictions on different domains of women’s empowerment and IPV in Pakistan. The study investigated the processes through which COVID-19 restrictions possibly resulted in an increased incidence of IPV among FDWs, a group of low-paid women who are often at a substantial risk of economic instability as well as IPV during the pandemic. Recruiting FDWs for in-depth interviews was challenging as these women usually work seven days a week while managing their own household at the same time. We provided modest incentives to compensate for their time. We also tried our best to arrange interviews at a time and place most convenient for women or at a venue of their choice to minimize disruptions to their daily life. Another potential challenge was that IPV, and likely women’s empowerment, is a sensitive topic for women. The research coordinator used her social networks to recruit participants, which helped build participants’ trust. We did our best to ensure complete privacy and confidentiality during the interview and removed all identification information from the transcripts. The main limitation of the study is that the findings cannot be generalized due to the snowball sampling technique. Also, the study was limited to FDWs who had good social and financial support from their employers/ baajis , which women from other sectors might not have. The study also recruited only those participants who were comfortable talking about their relationship dynamics. Therefore, the study may have missed the women experiencing the highest levels of IPV. Finally, while the COVID-19 pandemic is not yet over, the government of Pakistan had lifted most physical restrictions by May 2020, six months before the beginning of this study. Hence, there was a risk of recall bias by the time data was collected. Conclusion The study explored IPV patterns and how changes in empowerment influenced IPV patterns in Karachi during the pandemic. The study found women’s earnings during the lockdown and confinement with perpetrators to be driving factors for the increase in IPV incidence, informing policies to regulate the labor industry during crises situations. Climate change, including temperature rises, is likely to create a conducive environment for the spread of infections and other epidemics in the future.(44) Therefore, it is crucial to understand the processes which change the marital power dynamics during crises to mitigate the ‘shadow pandemic’ of violence against women. Declarations Contribution Statement BK: Conceptualization, Data curation, Formal Analysis, Investigation, Methodology, Software, Visualization, Writing – original draft, Writing – review & editing. MD: Conceptualization, Methodology, Supervision, Visualization, Writing – review & editing. AM: Conceptualization, Data curation, Supervision, Writing – review & editing. JW: Conceptualization, Data curation, Writing – review & editing. BK accepts full responsibility for the finished work and/or the conduct of the study, has access to the data, and controls the decision to publish. Disclaimer No conflict of interest. This article was prepared while Aubrey Spriggs Madkour was employed at Tulane University. The opinions expressed in this article are the author's own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. References WHO. World Health Organization (2020) WHO Director-General’s opening remarks at the media briefing on COVID-19–11 March 2020 Huaxia (2020) Pakistan announces lockdown of major provinces to curb COVID-19 spread. XINHUANET [Internet]. ; Available from: http://www.xinhuanet.com/english/2020-03/24/c_138910694.htm Shehzad R (2020) Countrywide lockdown stretched till May 9. The Express Tribune [Internet]. ; Available from: http://tribune.com.pk/story/2206167/1-countrywide-lockdown-stretched-till-may-9 Qureshi Z (2020) Covid-19: Pakistan extends lockdown until April 14. 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[Internet]. New York.; Available from: https://www.unfpa.org/sites/default/files/resource-pdf/COVID-19_A_Gender_Lens_Guidance_Note.pdf Ali TS, Asad N, Mogren I, Krantz G (2011) Intimate partner violence in urban Pakistan: prevalence, frequency, and risk factors. Int J Womens Health 3:105–115 Software VERBI VERBI Software. 2020 [cited 2022 Feb 24]. MAXQDA 2020 Online Manual. Available from: maxqda.com/help-max120welcome Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101 Birt L, Scott S, Cavers D, Campbell C, Walter F (2016) Member Checking: A Tool to Enhance Trustworthiness or Merely a Nod to Validation? Qual Health Res 26(13):1802–1811 Pakistan Bureau of Statistics. Household Integrated Economic Survey (HIES) 2018-19 [Internet] (2019) Available from: https://www.pbs.gov.pk/content/household-integrated-economic-survey-hies-2018-19 NIPS and ICF (2019) Pakistan Demographic and Health Survey 2017-18 Naz L, Siddiqui UA, Sriram S (2024) Examining contraceptive utilization behavior in Pakistani women. Reproductive Health. ;21(1) Kumari B, Do M, Madkour AS, Wisniewski JM (2024) Women’s empowerment and current contraceptive use in Pakistan: informed by theory of gender and power. Front Glob Womens Health. ;5 Bandial SZ (2020) An unseen pandemic is festering in Pakistan. Arab News Ali R, Khalid A (2021) COVID-19 and Domestic Violence in Pakistan: An Analysis of the Media Perspective. J Int Womens Stud 22(12):98–114 Perveen R (2021) Violence against Women & Girls in the Times of Covid-19 Pandemic Sifat RI (2020) Impact of the COVID-19 pandemic on domestic violence in Bangladesh. Asian J Psychiatr 53:102393 Mahar M, Increased (2020) DV after COVID-19 Lockdown. Modern Diplomacy. Modern Diplomacy Vora M, Malathesh BC, Das S, Chatterjee SS (2020) COVID-19 and domestic violence against women. Asian J Psychiatr 53:102227 2020/06/15 United Nations Human Rights (2020) COVID-19 and increase in gender based violence and discrimination against women Safdar M, Yasmin M (2020) COVID-19: A threat to educated Muslim women’s negotiated identity in Pakistan. Gend Work Organ Kottasová I, Donato V, Di (2020) Women are using code words at pharmacies to escape domestic violence during lockdown. CNN.com Sajid MI, Balouch SS, Abaidullah S (2020) New Bully in Town or More Opportunities: The Rise in Domestic Violence amidst COVID-19 Outbreak. Biomedica. ;36 Muldoon KA, Denize KM, Talarico R, Fell DB, Sobiesiak A, Heimerl M et al (2021) COVID-19 pandemic and violence: rising risks and decreasing urgent care-seeking for sexual assault and domestic violence survivors. BMC Med 19(1):1–9 Leone JM, Lape ME, Xu Y (2014) Women’s Decisions to Not Seek Formal Help for Partner Violence: A Comparison of Intimate Terrorism and Situational Couple Violence. J Interpers Violence 29(10):1850–1876 Winston A (March. 2020) Is the COVID-19 Outbreak a Black Swan or the New Normal. MIT Sloan Management Review Footnotes specific charity in Islam obligated religiously to the Muslims. Baaji (باجی): (in Urdu) Elder sisters – FDWs often call their female employers baajis in Karachi, Pakistan. Additional Declarations The authors declare potential competing interests as follows: Disclaimer: This article was prepared while Aubrey Spriggs Madkour was employed at Tulane University. The opinions expressed in this article are the author's own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. 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The opinions expressed in this article are the author's own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eShadow Pandemic: IPV Experiences of Female Domestic Workers in Karachi, Pakistan during the COVID-19 Lockdown.\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Key Message","content":"\u003cul\u003e\n \u003cli\u003eThe study is suggestive of \u0026lsquo;situational violence\u0026rsquo; related to economic hardships, rather than \u0026lsquo;intimate terrorism.\u0026rsquo;\u003c/li\u003e\n \u003cli\u003eRecommendation for legal aid, regulation of labor laws to provide paid leaves to women in low-paid jobs, and alternative employment opportunities for women in times of crises.\u003c/li\u003e\n \u003cli\u003eSurveys should explore the effectiveness of help seeking behaviors the women employed during the pandemic.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cp\u003eThe World Health Organization (WHO) declared the COVID-19 outbreak as a pandemic on March 11th, 2020, (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) The government of Pakistan imposed a nationwide lockdown on March 24th, 2020, (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), and extended it twice until May 9th, 2020 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), when the lockdown was eased gradually in phases (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The silent pandemic of gender-based violence (GBV) that escalated parallel to the COVID-19 pandemic is also called the ‘shadow pandemic’ due to the inadequate acknowledgment given to the issue (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e); most countries reported a 25–35% increase in domestic violence reports in the first month of their lockdowns (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) PUCAR-15, the police helpline in the socio-economically similar neighboring province of Punjab, reported a 25% surge in reported cases of GBV during the strict lockdown period (March 23rd to April 23rd, 2020), and a decrease of 10% once the strict lockdown was relaxed to a partial lockdown in May 2020 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Considering the global situation and reports from the neighboring province, a 25–30% surge in intimate partner violence (IPV) seems likely to have occurred in Karachi.\u003c/p\u003e \u003cp\u003eThree-fourths of informal workers across the globe have been hit by lockdowns due to the COVID-19 pandemic, mainly in urban areas (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) women being a considerable proportion of the affected informal sectors (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). The Pakistani Bureau of Statistics reports that 72% of the labor force participates in the informal sector and estimated 8.5\u0026nbsp;million domestic workers in Pakistan (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Being a metropolis, Karachi attracts migrants from other parts of the country for employment and a better livelihood. Hence, FDWs are an integral part of the informal sector in Karachi. FDWs, Because of COVID-19, most of them could not work during the lockdown (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Hence, these women were likely to spend more time at home, unemployed, with heightened stress, and with their husbands than in normal circumstances.\u003c/p\u003e \u003cp\u003eThere is a need to better understand IPV experiences among vulnerable populations like FDWs in Pakistan and the processes of empowerment that can exacerbate or mitigate such incidents during the COVID-19 lockdown. Most studies exploring the relationship between COVID-19 and IPV have employed either record-based data or internet-based surveys (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). However, there remains a gap in understanding the processes and nuanced IPV experiences for women during the pandemic lockdown. This study aims to fill the gap that how concepts of empowerment and IPV operationalize among domestic workers.\u003c/p\u003e\n\u003ch3\u003eConceptual Framework\u003c/h3\u003e\n\u003cp\u003eThe conceptual framework is based on Connell’s Theory of Gender and Power, which was operationalized by Wingood and DiClemente (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Figure\u0026nbsp;1 presents the domains of women’s empowerment and how we hypothesize them to relate to IPV experiences during the lockdown.\u003c/p\u003e \u003cp\u003eThe existing literature suggests that some intimate relationships depict power imbalance and control leading to severe or chronic IPV of all types, including verbal, physical, and sexual violence (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). However, some couples exhibit situational or acute violence, which is often less severe than intimate terrorism and infrequent (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), and often associated with catastrophes and conflict (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Hence, it may be suggested that the socio-economic crisis caused by the COVID-19 pandemic and preventive measures puts vulnerable women at an increased risk of IPV, as explained in Fig.\u0026nbsp;1. It presents how women’s empowerment relates to IPV during the COVID-19 lockdown. COVID-19 has caused multidimensional stressors, including loss of employment and financial instability(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e) Economic insecurity can lead to negative coping strategies including substance abuse (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), and stress, triggering violent behavior among potential perpetrators (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Increased physical confinement with a potentially violent spouse due to movement restrictions can increase exposure to a potential perpetrator(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e) Partners who might not be violent in normal times are also likely to feel more stressed due to a lack of social networking (Peterman, 2020). Such potential perpetrators may perceive violence as a coping mechanism to the perceived loss of control, triggering situational IPV or aggravating chronic violence (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). When men faced financial stress and helplessness, they endeavored to exercise their power and used violence against women to gain a sense of control(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e)\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe goal of this research is to investigate FDWs’ experiences and perceptions of IPV, women’s empowerment, social support, and their relationships during the 2020 COVID-19 lockdown from the perspective of FDWs. This exploratory research was designed to understand how COVID-19 restrictions and related factors may have influenced IPV experiences among FDWs in Karachi, Pakistan, and the role of social support in modifying IPV experiences.\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \n\n"},{"header":"Methods","content":"\u003cp\u003eAn exploratory qualitative study was conducted to understand the COVID-19 pandemic’s short-term impact on IPV experiences among FDWs in Karachi through in-depth interviews. A prevalence study in Karachi in 2011 reported that around 84% of women faced at least psychological violence during their lifetime (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) Hence, it was assumed that more than 80% of recruited women would have ever experienced IPV.\u003c/p\u003e\u003cp\u003eInterviews were conducted until ‘theoretical-saturation’ was achieved. Data were analyzed simultaneously with the interviews being conducted; when no new information was obtained, ‘saturation’ was achieved, data collection was stopped. Using snowball sampling 45 FDWs were approached face-to-face for the interview. Five women refused due to time constraints; 45 were interviewed for this study. Each woman was interviewed once for 30–40 minutes at a place most convenient for women to minimize the disruption to their daily life and ensuring privacy.\u003c/p\u003e\u003cp\u003eAn interview guide was developed based on Connell’s Theory of Gender and Power and the conceptual framework presented above. The semi-structured interview guide included questions on: a) COVID-19 lockdown-related experiences, including husband’s and wife’s employment status, financial resources, and physical confinement status, b) women’s empowerment, including their perception of different domains of empowerment and how it may have changed due to the pandemic and restrictions, and c) attitudes toward IPV, IPV experiences and patterns, if any, and how it may have changed due to the pandemic and restrictions. Fieldwork began after obtaining IRB approval from Tulane University, USA (SPHTM 2020 − 1868), and Jinnah Sindh Medical University, Pakistan (JSMU/IRB/2021/-404). The interview guide was validated for translation by an independent linguistic expert and pilot tested. Informed consent was taken verbally after explaining the research objectives. In-depth interviews were conducted by BK. The audio-recorded interviews were transcribed and analyzed along with field notes using Maxqda in Urdu (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Thematic analysis was conducted (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), and response patterns within the data were identified in two ways: an initial codebook was developed based on the theoretically informed concepts and the interview guide in a ‘deductive’ or ‘top-down’ approach. Coding was further conducted by BK by coding interview transcripts line-by-line, building upon the codebook. Next, axial coding was conducted using the revised codebook, whereby these codes were merged into themes through discussion. This way major themes were identified, in an ‘inductive’ or ‘bottom-up’ approach, for the patterns and factors associated with IPV in a lockdown.\u003c/p\u003e\u003cp\u003eThe thematic analysis was conducted following the six-step guide (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e); moving forward and back between the following steps: i) familiarizing with the data, ii) generating initial codes, iii) searching for themes, iv) reviewing themes, v) defining names, and vi) producing the report. Once preliminary findings were reached, member checking was conducted to explore the credibility of results to ‘check for accuracy and resonance with their experiences’ (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e); the six ’seed’ participants were contacted to verify the interpretation of their interviews. Verbatim quotes were compiled and translated into English for use in publications and research dissemination.\u003c/p\u003e\u003ch3\u003ePublic Involvement\u003c/h3\u003e\u003cp\u003ePatients or the public were not involved in the design, conduct, reporting, or dissemination plans of this research. The study was developed by the research team based on existing literature and identified gaps in understanding the experiences of partner violence among domestic workers.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe mean age of the participants and their husbands’ age was 34.4 and 39.8 years old, respectively. Most of the participants lived in joint households but no participants owned the houses they lived in; Most participants reported having a mobile phone in the household; only six had a plain personal mobile phone. One participant mentioned that women in her community were not allowed to keep a phone. Women were asked about media exposure because media was the primary source of dissemination of information during the lockdown. Fifteen participants had a television; others reported watching at their employers’ or neighbors’ houses.\u003c/p\u003e\n\u003cp\u003eThe women worked at various homes every day, working for 6-8 hours every day on average. The average monthly earnings of the women were PKR 12,040 ($70), ranging from PKR 4,000 ($23) to PKR 25,000 ($144). Most husbands earned more than their wives; their average monthly earnings were PKR 15,833 ($90), ranging from PKR 8,000 ($45) to PKR 30,000 ($171). However, ten husbands had no earnings long before the pandemic due to old age or sickness; women being either sole breadwinners, or their sons contributing.. Overall, the average monthly household earnings were PKR 33,719 ($193), ranging from PKR 20,000 ($114) to PKR 72,000 ($411), compared to the average monthly household earnings of Urban Sindh, that is, PKR 49902 ($285) (Pakistan Bureau of Statistics, 2019).\u003c/p\u003e\n\u003ch4\u003e\u003cem\u003eThematic Analysis Findings \u0026nbsp;\u003c/em\u003e\u003c/h4\u003e\n\u003cp\u003eThe four main themes identified were perceived changes during the COVID-19 lockdown in 1) patterns of IPV experiences, 2) factor’s influencing IPV experiences, and 3) social support.\u0026nbsp;\u003c/p\u003e\n\u003ch3 id=\"_Toc97565772\"\u003e\u003cstrong\u003eTheme 1: Patterns of IPV Experiences during COVID-19 lockdown\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe narratives from the interviews revealed differences in patterns of IPV experiences of women before the pandemic and during the COVID-19 lockdown. Most women (60% or n=24) in this study had experienced violence at least once from their husbands in their lifetime. Two-thirds of these women reported experiencing frequent IPV in the recent years before the pandemic (n=16), while a third of the women did experience IPV during their early years of marriage, but there was none in the last 6-10 years (n=8).\u003c/p\u003e\n\u003cp\u003eMost women who had been experiencing IPV in the recent years before the pandemic reported increased conflicts during the COVID-19 lockdown; thirteen women faced increased frequencies of IPV. Also, three out of the eight women, who had not experienced IPV in the last 6-10 years, now experienced violence during the lockdown. Even among the sixteen women who had never experienced IPV prior to the pandemic, nine of them experienced violence during the lockdown.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMy husband was fine previously. Now he gets angry with me and the kids. He beats up the kids. (FDW8)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eYes, (violence was) happening too much. (His) anger had increased, on me and on the kids. (He) used to curse more. Once he beat me too. (FDW11)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFor most women, violence, especially psychological, was a normalized phenomenon. Often, they could not distinguish between marital conflicts and verbal abuse, leading to a greater tolerance towards psychological violence. Almost every woman who experienced IPV during COVID-19 lockdown reported increased verbal abuse. Twelve women reported increased physical abuse, some to the extent of husbands beating the kids during the lockdown (n=4).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eYes, (we were) at home all the time, so there was more stress and more quarrels. (FDW6)\u003c/em\u003e\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eTheme 2: Factors influencing IPV experiences during COVID-19 Lockdown\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe study identified the major factors that influenced IPV experiences during COVID-19 lockdown. The identified factors contributed to women’s empowerment according to Theory of Gender and Power, as described below:\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eHousehold wealth and Financial Independence\u003c/h5\u003e\n\u003cp\u003eMost women felt that they could not make their ends meet during the lockdown; fifteen women did not get paid anything during the lockdown, and some of the employers either fully or partially paid another fourteen. On the other hand, twelve women were given paid leaves from all their employers. Some women reported receiving cash or grocery as charity or zakat\u003csup\u003e[1]\u003c/sup\u003e from their employers or other philanthropists (n=7).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNo, there was no work, so who will give the money (FDW9)\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOne baaji\u003c/em\u003e\u003csup\u003e[2]\u003c/sup\u003e\u003cem\u003e\u0026nbsp;sent me complete salary and grocery for two months. (FDW1)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAs mentioned above, ten husbands had not had any earnings for a long time, even before the pandemic. Among the rest, half were unpaid (n=15), and the rest were paid partially or fully during the COVID-19 lockdown. Some of the husbands with government jobs were paid regularly (n=5), while daily wagers were comparatively more financially constrained (n=11).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMy husband used to get meals too from his employers. (FDW7)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eHe does not have a (fixed) salary. (He) just works as a daily wager. He did not get anything (in the lockdown). (FDW8)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMy husband had a property (real estate) business. It went into loss. (FDW33)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eDuring the COVID-19 lockdown, some families had to take loans from their employers to cover expenses (n=6). Generally, participants reported their female employers (\u003cem\u003ebaajis\u003c/em\u003e) as their primary financial support. Some participants received assistance from the government (n=4), while two women complained of not being able to receive the assistance and were seeking help regarding the process.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIt had become difficult to arrange household expenses and groceries. Sometimes we cooked just lentils and sometimes potatoes for meals. (FDW2)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eJust like that, sometimes we would just eat green chilies, sometimes something else. It was extremely hard. I did not get paid anything from my baajis. There was nothing to eat. Children were starving too. Sometimes we would just borrow or do something else to make it. May God keep it well now. (FDW13)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNow kids are starving for two, three days. We will die this way. Ma’am, I am working for the kids. My loan needs to be paid off. The rent is overdue. He insults us. The landlord humiliates us. Even now, three months’ rent is unpaid. I cannot sleep at night. Keep thinking about how we will manage the household; how we will make a living. We cannot even make expenses for one day... 24-25 thousand (rent). Where do I get that? (FDW27)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMost women perceived financial constraints and joblessness to be the major factor contributing to their IPV experiences during COVID-19 lockdown. Often, women believed that their husbands’ stress about arranging meals for the family during the lockdown led them to be violent at home (n=12).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThere is tension, and trivial disputes keep happening. Obviously, there was income, and now there is none. When we are jobless and expenses are not met, there are fights. (FDW24)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eYes, (violence was) happening too much. Obviously, (he) did not get the money, so (his) anger had increased, on the kids and on me. (He) used to curse more. When one does not have anything to eat and no job either, anger will increase. Once, he beat me too. (FDW11)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAmong the fifteen participants who had no earnings during the COVID-19 lockdown, twelve experienced violence during the same period. A participant, who did not receive a salary during the lockdown, perceived financial constraints to be the reason for their IPV experience.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMy husband used to support me a lot, but when there are issues, and there is no work, then there are problems. Obviously, when there is nothing to eat, there are problems. (FDW33)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEight out of the fourteen women who had partial loss of income, and five out of eleven women who were paid fully, experienced some violence during the lockdown. A participant who continued to work for one employer, but not for the others (partially working), did not report any violent experiences.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNo, there were no quarrels. When we have (something to eat), we eat together. When we do not, we all just sit. (FDW32)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAmong the fifteen participants whose husbands had no earnings during the COVID-19 lockdown, ten experienced some violence during the same period. Even three out of the ten husbands who had not been working before the pandemic were violent towards their wives. Husbands with no income had an increased tendency for violence at home, as said by a participant:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eYes, (the violence was) happening too much. Obviously, (he) did not get the money, so (his) anger had increased on the kids and me. (He) used to curse more. Anger will obviously grow when one does not have any food or a job. Once, he beat me too. (FDW11)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFive out of eight women whose husbands had partial loss of income, and four out of seven women whose husbands were paid fully experienced some violence during the lockdown. A participant, whose husband was a government employee and was paid during the lockdown, did not report any violence.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNo, he was not violent toward me. (FDW2)\u003c/em\u003e\u003c/p\u003e\n\u003ch5\u003eWorkforce participation\u0026nbsp;\u003c/h5\u003e\n\u003cp\u003eThe majority of the FDWs were told by their employers not to come to work during the COVID-19 lockdown (n=27); however, the duration of being out of work varied and was not consistent with the official lockdown period. Most women stayed home for an average period of two months. Two women stayed out of work for 4-6 months. However, the earnings did not correlate with their work hours, as some were paid regardless of their working time.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eEmployers told us not to come for a few months. They said they did not have money and they would do their chores themselves. They told us not to come to work for three months. They called us for work after three months, then started paying us. (FDW39)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNine FDWs continued working for some employers during the COVID-19 lockdown, whereas some of their other employers told them not to come to work; only four women continued to work fully during the lockdown. Two women had shorter work hours and would hastily finish their tasks because of employers’ fears of contracting COVID-19.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eBaajis would sometimes call me for work and sometimes give me an off. (FDW23)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFive out of the nine women who worked partially, and two out of four women who worked during the lockdown, experienced some violence during the same period. A woman who went to work during the lockdown did not experience IPV. Among the twenty-seven participants who did not work during the COVID-19 lockdown, eighteen experienced violence during the same period. One participant who did not work during the lockdown perceived increased violence due to physical confinement with the perpetrator.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eYes, we were home all day, so there was more stress, fights, and quarrels. (FDW6)\u003c/em\u003e\u003c/p\u003e\n\u003ch5\u003ePHYSICAL Confinement\u003c/h5\u003e\n\u003cp\u003eMost women were confined at home with their usual family members, primarily due to enforced lockdown and the unavailability of public transport.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA few (n=4) women believed staying together in the same house all the time increased conflicts and violence at home.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIf the environment at home is unpleasant and stressful, you start despising each other’s faces. (We) could not go out either. What can one do then except getting angry? (FDW22)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eYes, when (we) are sitting idle, it happens. Quarrels, conflicts, fights, etc. (FDW21)\u003c/em\u003e\u003c/p\u003e\n\u003ch5\u003eHousehold decision-making\u0026nbsp;\u003c/h5\u003e\n\u003cp\u003ePrior to the pandemic, the eldest male member of the household, like the husband in a nuclear family or father-in-law in a joint family, was usually the primary decision-maker. Some women participated in the decision-making along with their husbands (n=7). The same continued to be valid during the lockdown.\u003c/p\u003e\n\u003cp\u003eHowever, one woman perceived that men were wrong to interfere if the women were the breadwinners, especially in financial constraints, like during the lockdown.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eWomen faced the most problems. They had to see her house and also work outside. There are no jobs. They had to fulfill (the expenses) with less money. When the men are at home, there are more expenses. When they keep grumbling, you lose your mind. They would not bring anything (money) but ask us. What will we give you? Have you given me some money (to save), so we could give you it back? (FDW20)\u003c/em\u003e\u003c/p\u003e\n\u003ch5\u003eAccess to healthcare\u0026nbsp;\u003c/h5\u003e\n\u003cp\u003eAlmost no woman visited any healthcare facility during the lockdown. The most common reason for not having access to healthcare during the lockdown included lack of money or transport, resorting to self-medication. However, some women avoided visiting a healthcare facility since the COVID-19 lockdown due to fears of contracting the virus (n=7).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNo, I did not go to the hospital. I was scared due to Corona. (FDW6)\u003c/em\u003e-\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eWe did not need to (go to a hospital) during the lockdown. We took so much care that there was no need. (FDW7)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eBaaji helped me. She gave me three medicines, and I took Panadol for fever. Also, I took care and drank herbal teas. Then I got better. (FDW8)\u003c/em\u003e\u003c/p\u003e\n\u003ch5\u003eSexual negotiation\u0026nbsp;\u003c/h5\u003e\n\u003cp\u003eOur sample participants had mixed experiences about the ability to negotiate sexual intercourse. While half of the women did not state that their husbands were coercive about sexual intercourse and thought that their wish and wellness were respected, the other half perceived their husbands’ to be coercive about sexual intercourse, which continued during the COVID-19 lockdown.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eAttitudes toward IPV\u003c/h5\u003e\n\u003cp\u003eThe women who experienced IPV during the COVID-19 lockdown tried to justify their husbands’ actions; they tended to accept IPV as a justified consequence of financial constraints during the lockdown period (n=12).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eWhen one does not get any food or job, obviously (husband’s) anger will rise. (FDW12)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eYes, (he beats) when he gets into tension or when he is worried about money, like in the lockdown (FDW17)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNo, my husband is genuinely nice. But when two people are constantly at home, and there is tension, so obviously, (he) will get somewhat angry. (FDW24)\u003c/em\u003e\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eTheme 3: Social Support during COVID-19 lockdown\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe study identified the key social support in the women’s lives during the COVID-19 lockdown. The most common source of social support identified by 14 women during the COVID-19 lockdown came from their \u003cem\u003ebaajis\u003c/em\u003e or their female employers. These women were financially supported by their employers, either by paid holidays or being aided by charity or \u003cem\u003ezakat\u003c/em\u003e during the COVID-19 lockdown. The second crucial social support theme identified in these interviews was a reaffirmation of their belief in God. Eleven women restated their trust in \u003cem\u003eAllah\u003c/em\u003e to solve their challenges, be it their financial constraints, pandemic fears, or marital relations.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eWe ask Allah and then request our baajis. (FDW11)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eGod is the one who does everything. Bhabhi (employer) used to send the grocery and salary. Once, I sent my father to bring the salary. She also paid my child’s (school) fees. (FDW26)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eGenerally, women with fully paid salaries or financial aid likely reported more financial stability and, in most cases, their home environment to be peaceful.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eWe would just stay at home depressed. Whatever was cooked, we would just eat gratefully. (FDW1)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAs described earlier, most women normalized IPV and considered it as a way for men to release stress during a period of financial constraints. Some women resorted to patience and prayers, with little support or options for help (n=3).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eI would cry out praying to Allah. Who else helps? (FDW3)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMost women in our sample did not have close relatives in Karachi, as they had migrated from various villages in Pakistan for employment. A common experience was not being able to visit with their relatives due to strict lockdown (n=11). Some women perceived the lockdown period to be lonely without any social support (n=4).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eYes, relatives used to come, but since Corona, the guards do not let guests inside the society. (FDW2).\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThree women left Karachi for the lockdown period to stay with relatives in their villages or hometowns. The reasons given by these women were either to cut down living expenses in the city or to evade the violent behaviors of their husbands.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eHe became annoyed. He showed more anger.\u003c/em\u003e\u003cem\u003e\u0026nbsp;I took my kids and went to my aunty. I went to Punjab. (He) used to say it is expensive. What will we eat? How will we live? I had a child (delivery). He was one month old, that is why he sent me to Punjab. (FDW9)\u003c/em\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003ePakistan has a prevalence of approximately 30% reported lifetime IPV among ever-married women; however, more than half of these women do not seek help (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e) This empirical study examined the IPV patterns and the factors that influence IPV experiences during the COVID-19 associated lockdown in Karachi, Pakistan. Research increasingly highlights that a dyadic characteristics, such as their fertility preferences, spousal age differences, and bargaining powers, play a critical role in determining women's health (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). The silent pandemic of GBV or \u0026lsquo;shadow pandemic\u0026rsquo; escalated parallel with the COVID-19 pandemic (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). It is imperative to understand the IPV experiences among vulnerable populations and the processes which influence these experiences during crises like the COVID-19 pandemic, which has caused a widespread lockdown and financial constraints. This research aimed to investigate FDWs\u0026rsquo; experiences and perceptions of IPV, women\u0026rsquo;s empowerment, social support, and their relationships during the first COVID-19 lockdown in 2020 from the perspective of FDWs. Specifically, the focus was on patterns of IPV experiences and influences of potential changes in women\u0026rsquo;s empowerment on IPV experiences among the FDWs in Karachi, Pakistan.\u003c/p\u003e \u003cp\u003eThe first theme described patterns of IPV experiences among FDWs in Karachi during the COVID-19 lockdown, including: i) increases in IPV experiences, especially among women who had not been experiencing IPV pre-pandemic, and ii) patterns of increased emotional and psychological abuse and conflicts, along with physical violence. The findings are consistent with the Sustainable Social Development Organization\u0026rsquo;s report of an increase of 200% in IPV in Pakistan during COVID-19 (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Other studies in Pakistan also reported similar patterns of emotional abuse, like \u0026lsquo;constant criticism, intimidation, and disapproval of daily chores (Ali \u0026amp; Khalid, 2021). However, most reports focusing on all types of GBV, rather than IPV specifically, during the COVID-19 lockdown in Pakistan, reported physical abuse or more severe crimes, based primarily on police data and media reports (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThe second theme described factors and processes, contributing to women\u0026rsquo;s empowerment, that influenced IPV experiences among FDWs in Karachi during the COVID-19 lockdown, including: i) financial constraints including overall decreased household income leading to stress about arranging household expenses, ii) ) most women not being able to work, or working only part of the time or shorter hours, iii) physical confinement with usual family members due to strict lockdown enforced by law agencies or the unavailability of public transport, and iv) tolerance of husband\u0026rsquo;s violent behavior on the pretext of financial stress. Similar to this study\u0026rsquo;s findings, the limited literature has suggested financial stress and physical confinement to be direct causes of increases in IPV during the pandemic. A letter to the editor reported a rise in emotional violence in Bangladesh among married women; the probable reason was increased frustrations among male family members due to financial stress and inadequate social opportunities(Sifat, 2020). Also, news blogs suggest that most women, regardless of their working status, were confined with their families at home during the lockdown, having no escape from the perpetrator (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThe theme also identified the influence of changes in women\u0026rsquo;s empowerment on IPV experiences among FDWs in Karachi during the COVID-19 lockdown, including: i) increased IPV experiences among women who had no earnings during the lockdown, and ii) husbands without financial resources being more violent at home. Similar to this study\u0026rsquo;s findings, other authors have associated domestic violence during the pandemic to wife\u0026rsquo;s unemployment and household financial stress, lack of social support, and movement restrictions (Ali \u0026amp; Khalid, 2021; Vora, 2020). The UN Human Rights report indicated that the pandemic and its associated issues, like financial crises, and restricted movement, had transformed home into an intimidating place for women(\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA final theme described the perceived changes in their social support and how these changes influenced IPV experiences among FDWs in Karachi during the COVID-19 lockdown, including: i) primary support system during the lockdown being their employers or \u003cem\u003ebaajis\u003c/em\u003e, ii) firm religious faith and hope that God will improve their life someday, and iii) leaving the city to be with other family and away from the perpetrator. The findings are important as when women do not have an alternative support system, the tendency to report IPV is often extremely low (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eOur study findings shed light on understanding the implications of the government\u0026rsquo;s COVID-19 restrictions and help explore innovative solutions to mitigate IPV incidents and make these resources accessible on multiple platforms to maximize reach (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e) The government\u0026rsquo;s \u0026lsquo;Stay Home, Stay Safe\u0026rsquo; campaign may have inadvertently compelled women to spend more time with potential perpetrators (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). In addition, the shift of economic autonomy and dependency of these women in informal economies made them vulnerable to exploitation and violence (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e) Law enforcing personnel should be trained to empathize and understand that home could become an unsafe environment during the lockdown, and IPV victims might need to be evacuated.\u003c/p\u003e \u003cp\u003eSeveral measures the Pakistani government took to tackle GBV during the lockdown were deemed insufficient and symbolic, such as multiple helpline numbers (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Similarly, there were no significant contributions of civil society to mitigating GBV (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). There was an acknowledgment of increases in GBV incidents by the government; however, there has not been an organized reporting system for GBV cases (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e) The study is suggestive of \u0026lsquo;situational violence\u0026rsquo; related to economic hardships rather than \u0026lsquo;intimate terrorism\u0026rsquo;; often, help-seeking behaviors of victims were not common in these cases (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). Therefore, the increased IPV incidence during the pandemic warrants enhanced measures to distribute resources and make them more accessible to vulnerable groups. Furthermore, the study suggests that while all women did not experience IPV, the children were subjected to violence. The incidental finding suggests exploring the impact of COVID-19 lockdown on violence against children.\u003c/p\u003e \u003cp\u003eThe study has identified the lack of economic empowerment, financial constraints, and physical confinements to be associated with increased IPV experiences during the pandemic. At the same time, social support was found to be an alleviating factor. These findings suggest that the government of Pakistan could arrange for legal aid and alternative employment opportunities for women during crises. Also, labor laws should be regulated, so women involved in low-paid jobs could avail paid leaves in times of crisis. During a pandemic, access to phones, media, and the internet, which is often limited, may become more constrained. Help-seeking becomes more challenging when victims are confined with potential perpetrators. Hence, engaging the community groups identified as social support, like the employers and religious leaders, may help bridge the gap between the victim and GBV-focused initiatives; they can play a crucial role in advocacy, improving access as well as building trust for the GBV services. Secondly, media could play a vital role in disseminating information and advocacy through commercials, drama, and documentaries of survivors and empowered women. Hence, a multi-dimensional approach focused on advocacy, empowerment, and support may build confidence in women to seek help.\u003c/p\u003e \u003cp\u003eTo our knowledge, this is the first empirical study exploring the impact of COVID-19 restrictions on different domains of women\u0026rsquo;s empowerment and IPV in Pakistan. The study investigated the processes through which COVID-19 restrictions possibly resulted in an increased incidence of IPV among FDWs, a group of low-paid women who are often at a substantial risk of economic instability as well as IPV during the pandemic.\u003c/p\u003e \u003cp\u003eRecruiting FDWs for in-depth interviews was challenging as these women usually work seven days a week while managing their own household at the same time. We provided modest incentives to compensate for their time. We also tried our best to arrange interviews at a time and place most convenient for women or at a venue of their choice to minimize disruptions to their daily life. Another potential challenge was that IPV, and likely women\u0026rsquo;s empowerment, is a sensitive topic for women. The research coordinator used her social networks to recruit participants, which helped build participants\u0026rsquo; trust. We did our best to ensure complete privacy and confidentiality during the interview and removed all identification information from the transcripts.\u003c/p\u003e \u003cp\u003eThe main limitation of the study is that the findings cannot be generalized due to the snowball sampling technique. Also, the study was limited to FDWs who had good social and financial support from their employers/\u003cem\u003ebaajis\u003c/em\u003e, which women from other sectors might not have. The study also recruited only those participants who were comfortable talking about their relationship dynamics. Therefore, the study may have missed the women experiencing the highest levels of IPV. Finally, while the COVID-19 pandemic is not yet over, the government of Pakistan had lifted most physical restrictions by May 2020, six months before the beginning of this study. Hence, there was a risk of recall bias by the time data was collected.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study explored IPV patterns and how changes in empowerment influenced IPV patterns in Karachi during the pandemic. The study found women’s earnings during the lockdown and confinement with perpetrators to be driving factors for the increase in IPV incidence, informing policies to regulate the labor industry during crises situations. Climate change, including temperature rises, is likely to create a conducive environment for the spread of infections and other epidemics in the future.(44) Therefore, it is crucial to understand the processes which change the marital power dynamics during crises to mitigate the ‘shadow pandemic’ of violence against women.\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eContribution Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBK: Conceptualization, Data curation, Formal Analysis, Investigation, Methodology, Software, Visualization, Writing – original draft, Writing – review \u0026amp; editing. MD: Conceptualization, Methodology, Supervision, Visualization, Writing – review \u0026amp; editing. AM: Conceptualization, Data curation, Supervision, Writing – review \u0026amp; editing. JW: Conceptualization, Data curation, Writing – review \u0026amp; editing.\u003c/p\u003e\n\u003cp\u003eBK accepts full responsibility for the finished work and/or the conduct of the study, has access to the data, and controls the decision to publish.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclaimer\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo conflict of interest.\u003c/p\u003e\n\u003cp\u003eThis article was prepared while Aubrey Spriggs Madkour was employed at Tulane University. The opinions expressed in this article are the author's own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWHO. 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Biomedica. ;36\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuldoon KA, Denize KM, Talarico R, Fell DB, Sobiesiak A, Heimerl M et al (2021) COVID-19 pandemic and violence: rising risks and decreasing urgent care-seeking for sexual assault and domestic violence survivors. BMC Med 19(1):1\u0026ndash;9\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeone JM, Lape ME, Xu Y (2014) Women\u0026rsquo;s Decisions to Not Seek Formal Help for Partner Violence: A Comparison of Intimate Terrorism and Situational Couple Violence. J Interpers Violence 29(10):1850\u0026ndash;1876\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWinston A (March. 2020) Is the COVID-19 Outbreak a Black Swan or the New Normal. MIT Sloan Management Review\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Footnotes","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e specific charity in Islam obligated religiously to the Muslims.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Baaji (باجی): (in Urdu) Elder sisters \u0026ndash; FDWs often call their female employers \u003cem\u003ebaajis\u003c/em\u003e in Karachi, Pakistan.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Tulane University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"IPV, Pakistan, women’s empowerment, Covid-19 lockdowns","lastPublishedDoi":"10.21203/rs.3.rs-8479706/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8479706/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eBackground: \u003c/strong\u003e\u003c/em\u003eThe ‘shadow pandemic’ of gender-based violence escalated parallel with the COVID-19 pandemic. This study explored how COVID-19 lockdowns may have impacted women’s empowerment and IPV patterns and the role of social support among female domestic workers (FDWs) in Pakistan.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e \u003c/em\u003eExploratory qualitative research with in-depth interviews was conducted, based on Connell’s Theory of Gender and Power. Married FDWs were recruited by snowballing (n=40). Themes were identified for patterns and factors associated with IPV. Data were analyzed using Maxqda by conducting thematic coding.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eResults: \u003c/strong\u003e\u003c/em\u003eMost FDWs in the sample lost jobs during lockdown; or paid partially. Conflicts increased in the family, primarily due to financial constraints. Loss of financial resources were more likely to experience IPV than participants without any economic loss. Most participants resorted to prayers and patience. Almost all were reluctant to seek help from police; nearly no one had information or access to organizations that support women in similar situations.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003c/em\u003e It is crucial to understand the processes of changing marital power dynamics during crises to mitigate the ‘shadow pandemic’ of violence against women. The study informs policies to regulate the labor industry, especially during crises situations.\u003c/p\u003e","manuscriptTitle":"Shadow Pandemic: IPV Experiences of Female Domestic Workers in Karachi, Pakistan during the COVID-19 Lockdown.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-06 17:14:44","doi":"10.21203/rs.3.rs-8479706/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4830fd6a-a7be-4797-9564-78470861af78","owner":[],"postedDate":"January 6th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":60372263,"name":"Gender Studies"},{"id":60372264,"name":"Women's studies"}],"tags":[],"updatedAt":"2026-01-06T17:14:44+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-06 17:14:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8479706","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8479706","identity":"rs-8479706","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}