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Research Article | DOI: https://doi.org/10.31579/2690-8808/262
1Senior Consultant, Obstetrics Gynecology, TapanBhai Mukesh Bhai Patel Memorial Hospital, Medical College and Research Centre Shirpur, Dhule, Maharashtra, India.
2Additional Professor, Obstetrics Gynaecology, All India Institute of Medical Sciences, Bibinagar-508126 Hyderabad Metropolitan Region, Telangana, India.
*Corresponding Author: Shakuntala Chhabra, Senior Consultant, Obstetrics Gynecology, TapanBhai Mukesh Bhai Patel Memorial Hospital, Medical College and Research Centre Shirpur, Dhule, Maharashtra, India.
Citation: Shakuntala Chhabra and Kumar N, (2025), Sufferings of Elderly Rural women due to COVID-19 in Communities of a Remote Region: An Observational Study, J, Clinical Case Reports and Studies, 6(5); DOI:10.31579/2690-8808/262
Copyright: ©, 2025, Shakuntala Chhabra. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 12 June 2025 | Accepted: 19 June 2025 | Published: 30 June 2025
Keywords: Pandemic, COVID-19; elderly women; suffering; physical violence; sexual violence
Background: COVID-19 pandemic caused an unprecedented impact on society globally.
Objective: Study was conducted to know about sufferings experienced by rural elderly women in a remote hilly region.
Methodology: Community-based, cross-sectional, observational study included 4500 randomly selected tribal women of ≥50, who resided in 140 villages and consented to participate. Face-to-face interviews of participants were conducted, for 15-30 minutes, using a semi-structured questionnaire regarding sufferings of elderly women during COVID-19 pandemic.
Results: Of 4500 women interviewed, majority (47.2%) were 50-59 years old, low educated (40.4%), agriculture labourers (44.1%) and of lower economic class (53.8%). Of all participants, 73.5% reported change in everyday life, 25.9% change in meals, 30.7% in work and working environment and 39.5% in health care. Of all the women interviewed, 45.9% reported physical violence (PV), majority (74.1%) by husbands, 0.4% suffered sexual violence (SV). Modes of PV were mostly slapping, hitting, or kicking. Of all the women, who suffered PV, SV, and majority informed their family members, but only 7.0% informed police, however 98.6% who suffered sought healthcare. Socio-demographic factors like age, education, economic class, and occupation had a significant relationship with sufferings of women during pandemic.
Conclusion: Covid -19 Pandemic had significant impact on rural elderly women’s lives, 45.9% and 0.4% of women respectively reported having suffered PV and SV at home during pandemic. It is therefore necessary to generate awareness, formulate laws, policies for protection of elderly women during such pandemic.
Aging naturally brings changes to body and its functions, influencing health, wellness, and overall quality of life. The COVID-19 pandemic disrupted the lives of older adults by further restricting their movements and limiting social interactions, with particularly severe effects on rural elderly women who often live in isolation. [1]
Elderly women faced unique hardships, as the pandemic compounded everyday challenges and heightened their vulnerability. However, studies showed that providing accurate and reliable information helped reduce pandemic-related fears, especially among elderly women with chronic conditions. [2]
The COVID-19 pandemic disrupted lives across all age groups worldwide, but older adults and women have been particularly hard hit. Their heightened vulnerability stemmed from several factors. Compared to younger individuals, older adults are more likely to live with chronic health conditions, and their aging immune systems struggle to fend off illnesses, infections, and viruses effectively. When they fall ill, recovery tends to be slower and more complex, often leading to prolonged health challenges. [3] The COVID-19 pandemic disrupted access to essential healthcare and long-term care services. Beyond physical health, the pandemic exacerbated social isolation. Many older women, especially those living alone, saw their daily routines shrink, with fewer walks, limited outings, and minimal face-to-face interactions. This isolation contributed to rising feelings of loneliness and a surge in mental health challenges. Although stress related to work and finances may have been less acute for this age group compared to younger adults, the emotional strain of isolation and health-related anxieties were deeply felt. [4] The COVID-19 pandemic exposed older adults to a range of challenges, including abuse, neglect, insecurity, and health issues within their families and communities. [5] Widespread fear, anxiety, loneliness, and increased dependence have intensified these struggles, highlighting a serious societal concern. Factors such as social isolation, cognitive decline, physical frailty, and reliance on caregivers heightened the risk of elder abuse. [6, 7]
Objective
A community-based study was conducted to explore the sufferings of elderly women during the COVID-19 pandemic in a rural remote region.
Study design: Observational cross-sectional study
Study setting and duration: The study was conducted over one year in a total of 140 tribal villages in remote, forestry, and hilly region. These villages were around the village with the health facility, the study centre.
Inclusion criteria: - Randomly 30-35 women of ≥50 years of age from each village, willing for interview, were enrolled as study participants, as some villages were small and others large.
Exclusion criteria: - Women abive50 years of age, those with mental health conditions, and individuals unwilling to participate were excluded from the study.
Sample size: The calculated sample size was 4500 with 95 % confidence and 2 % absolute precision. The sample size was rounded after calculating using a free online statistical calculator (statulator) [8]
Data Collection
After the Institutional ethical committee’s approval and informed consent from the participants, socio-demographic features of all the participants including age, education, occupation, economic status, and parity were collected by a research assistant (trained nurse midwife) and were recorded on a pre-designed tool, a semi-structured questionnaire with some open and others close-ended questions. Face-to-face interviews of the study subjects were conducted regarding the sufferings faced by the elderly women during the COVID-19 pandemic. Information was collected about changes in everyday work, health care, physical violence (PV) and sexual violence (SV) against them at home, and the action taken. Each interview lasted for around 15 minutes, maintaining confidentiality and privacy in an area convenient to participants and the research assistant who recorded information on the hard tool.
Of all the women interviewed, the majority (47.2%) were of50-59 years of age, educated up to primary level (40.4%), agriculture labourer (44.1%), belonged to low economic class (53.8%) and had one or two births (52.0%). Of the 4500 women interviewed, 3306(73.5%) reported changes in their everyday lives during the COVID-19 pandemic, 856 (25.9%) reported changes in their meals due to lockdown, loss of family members employment, problems in agriculture, and poverty. Of 3306 women, 1015(30.7%) reported change in their work and working environment due to lockdown and loss of jobs and 1306(39.5%) reported change in health care due to lock down as many were not able to reach hospitals for their ailments There was lack of available health services with financial constraints also. The remaining 129(3.9%) women reported other changes like mental health, fear of infection, insecurity, change of homes due to shifting to other places when jobs were lost, school drop-outs of children, etc.
Of 4500 women, a total of 2066 (45.9%) reported increased PV at their homes during the pandemic compared to the pre-pandemic period. Of these 2066 women, 1530 (74.1%) reported PV by their husbands, 150(7.3%) by sons, or sons-in-law, 361 (17.5%) by daughters, and daughters-in-law and in the remaining 25(1.2%) other relatives, grandsons, and grand-daughters were responsible. Table II depicts the relationship between the various socio-demographic features of women and PV at home by family members (Table II). When interviewed about the frequency and mode of PV at home, of 2066 women, 1690 (81.8%) reported once or occasional episodes of PV, 376 (18.2%) reported regular PV at home. The majority (80.2%) reported slapping, hitting by hands, or kicking as the most common modes of PV followed by hitting with bar rods or burning (18.8%) and the remaining 1.0% reported other modes like hitting with brooms, foot wares, utensils, etc. The majority of these sufferers were of 50-59 years of age, had low education, were agricultural laborers by occupation, and belonged to a low economic class. Table II depicts the relationship of socio-demographic features of women with the frequency and mode of PV suffered at home (Table II). Furthermore, of the total of 4500 women interviewed, 17(0.4%) reported SV at their homes during the pandemic, all reporting the start of SV during the pandemic, none in the pre-pandemic period. Of these 17 women, all (100%) reported SV during sleep hours and by persons other than their husbands including neighbours, distant relatives, or unknown. Table III depicts the relationship between the socio-demographic features of women and SV at home (Table III). All these women who suffered SV belonged to 50-59 years of age, the majority were illiterate (59.0%), homemakers (59.0%), belonged to a lower economic class (82.3%) and had previous one of two childbirths (88.2%).
Of all the women who suffered PV and SV, (2083) informed someone, including family members (92.1%), police (7.0%), and others like neighbours, friends, and distant relatives (0.9%) (Table IV). Of these 2083 women, 2053(98.6%) sought healthcare, 64.4% from Sub centres (SC) or Primary Health Centres (PHC), 29.5% from Sub-district hospital (SDH)/District hospital (DH), and the remaining 6.1% from private hospitals or dispensaries. The relationship between the action taken and health care sought for PV and SV suffered at home and demographic factors is shown in Table IV (Table IV).
Table I: Changes in Everyday Life of Elderly Women during the COVID-19 Pandemic
| Variables | Total | Types | |||||||||
| Age (Years) | Every Day Life | % | Meals | % | Work | % | Health Care | Others | % | ||
| ≥50-≤59 | 2123 | 1503 | 70.8 | 310 | 20.6 | 293 | 19.5 | 822 | 54.7 | 78 | 5.2 |
| ≥60-≤69 | 1565 | 1302 | 83.2 | 469 | 36.0 | 448 | 34.4 | 342 | 26.3 | 43 | 3.3 |
| ≥70 | 812 | 501 | 61.7 | 77 | 15.4 | 274 | 54.7 | 142 | 28.3 | 08 | 1.6 |
| Total | 4500 | 3306 | 73.5 | 856 | 25.9 | 1015 | 30.7 | 1306 | 39.5 | 129 | 3.9 |
| Education | |||||||||||
| Illiterate | 1495 | 1184 | 79.2 | 338 | 28.5 | 401 | 33.9 | 407 | 34.4 | 38 | 3.2 |
| Primary | 1818 | 1220 | 67.1 | 228 | 18.7 | 324 | 26.5 | 605 | 49.6 | 63 | 5.2 |
| Secondary / Higher Secondary | 997 | 809 | 81.1 | 273 | 33.7 | 257 | 31.8 | 251 | 31.0 | 28 | 3.5 |
| Graduate | 190 | 93 | 48.9 | 17 | 18.3 | 33 | 35.5 | 43 | 46.2 | 0 | 0.0 |
| Total | 4500 | 3306 | 73.5 | 856 | 25.9 | 1015 | 30.7 | 1306 | 39.5 | 129 | 3.9 |
| Profession | |||||||||||
| Home Maker | 1340 | 982 | 73.3 | 170 | 17.3 | 363 | 36.9 | 392 | 39.9 | 57 | 5.8 |
| Agriculture Laborer | 1986 | 1520 | 76.5 | 312 | 20.5 | 487 | 32.0 | 649 | 42.7 | 72 | 4.7 |
| Casual Laborer* | 1014 | 719 | 70.9 | 304 | 42.3 | 155 | 21.6 | 260 | 36.2 | 0 | 0.0 |
| Shop Keeper | 160 | 85 | 53.1 | 70 | 82.3 | 10 | 11.8 | 5 | 5.9 | 0 | 0.0 |
| Total | 4500 | 3306 | 73.5 | 856 | 25.9 | 1015 | 30.7 | 1306 | 39.5 | 129 | 3.9 |
| Economic Status | |||||||||||
| Upper Class | 92 | 68 | 73.9 | 2 | 2.9 | 12 | 17.6 | 52 | 76.5 | 2 | 2.9 |
| Upper Middle Class | 142 | 108 | 76.1 | 9 | 8.3 | 25 | 23.1 | 72 | 66.7 | 2 | 1.8 |
| Middle Class | 625 | 433 | 69.3 | 110 | 25.4 | 84 | 19.4 | 211 | 48.7 | 28 | 6.5 |
| Lower Middle Class | 1219 | 870 | 71.4 | 246 | 28.3 | 221 | 25.4 | 346 | 39.8 | 57 | 6.5 |
| Lower Class | 2422 | 1827 | 75.4 | 489 | 26.8 | 673 | 36.8 | 625 | 34.2 | 40 | 2.2 |
| Total | 4500 | 3306 | 73.5 | 856 | 25.9 | 1015 | 30.7 | 1306 | 39.5 | 129 | 3.9 |
| Parity | |||||||||||
| P 0 | 690 | 577 | 83.6 | 197 | 34.1 | 247 | 42.8 | 102 | 17.7 | 31 | 5.4 |
| P 1 - P 2 | 2341 | 1658 | 70.8 | 423 | 25.5 | 416 | 25.1 | 762 | 45.9 | 57 | 3.4 |
| >P 3 | 1469 | 1071 | 72.9 | 236 | 22.0 | 352 | 32.9 | 442 | 41.3 | 41 | 3.8 |
| Total | 4500 | 3306 | 73.5 | 856 | 25.9 | 1015 | 30.7 | 1306 | 39.5 | 129 | 3.9 |
*Small Scale, (Food, Shoes making, Bamboo items) Industry, Welding Workshop, Brick furnace
Table II: Physical Violence against Elderly Women at Home during COVID-19
| Variables | Total | Physical Violence
| Frequency | Mode Of Violence | |||||||||||||||||
| Age (Years) | Yes | % | If Yes | Once | % | More times / Regular | % | Slap / Hitting / Kicking | % | Bar / Rod / Burns | % | Others | % | ||||||||
| Husband | % | Son / Son in law | % | Daughter / Daughter in law | % | Others | % | ||||||||||||||
| ≥50-≤59 | 2123 | 940 | 44.3 | 727 | 77.3 | 80 | 8.5 | 121 | 12.9 | 12 | 1.3 | 814 | 86.6 | 126 | 13.4 | 800 | 85.1 | 130 | 13.8 | 10 | 1.1 |
| ≥60-≤69 | 1565 | 608 | 38.8 | 404 | 66.4 | 45 | 7.4 | 150 | 24.7 | 9 | 1.5 | 453 | 74.5 | 155 | 25.5 | 441 | 72.5 | 159 | 26.2 | 8 | 1.3 |
| ≥70 | 812 | 518 | 63.8 | 399 | 77.0 | 25 | 4.8 | 90 | 17.4 | 4 | 0.8 | 423 | 81.7 | 95 | 18.3 | 415 | 80.1 | 100 | 19.3 | 3 | 0.6 |
| Total | 4500 | 2066 | 45.9 | 1530 | 74.1 | 150 | 7.3 | 361 | 17.5 | 25 | 1.2 | 1690 | 81.8 | 376 | 18.2 | 1656 | 80.2 | 389 | 18.8 | 21 | 1.0 |
| Education | |||||||||||||||||||||
| Illiterate | 1495 | 761 | 50.9 | 577 | 75.8 | 56 | 7.4 | 110 | 14.5 | 18 | 2.4 | 646 | 84.9 | 115 | 15.1 | 626 | 82.3 | 120 | 15.8 | 15 | 2.0 |
| Primary | 1818 | 1036 | 57.0 | 721 | 69.6 | 69 | 6.7 | 241 | 23.3 | 5 | 0.5 | 791 | 76.4 | 245 | 23.6 | 782 | 75.5 | 250 | 24.1 | 4 | 0.4 |
| Secondary / Higher Secondary | 997 | 259 | 26.0 | 222 | 85.7 | 25 | 9.7 | 10 | 3.9 | 2 | 0.8 | 243 | 93.8 | 16 | 6.2 | 238 | 91.9 | 19 | 7.3 | 2 | 0.8 |
| Graduate | 190 | 10 | 5.3 | 10 | 100.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 10 | 100.0 | 0 | 0.0 | 10 | 100.0 | 0 | 0.0 | 0 | 0.0 |
| Total | 4500 | 2066 | 45.9 | 1530 | 74.1 | 150 | 7.3 | 361 | 17.5 | 25 | 1.2 | 1690 | 81.8 | 376 | 18.2 | 1656 | 80.2 | 389 | 18.8 | 21 | 1.0 |
| Profession | |||||||||||||||||||||
| Home Maker | 1340 | 955 | 71.3 | 655 | 68.6 | 60 | 6.3 | 221 | 23.1 | 19 | 2.0 | 731 | 76.5 | 224 | 23.5 | 709 | 74.2 | 229 | 24.0 | 17 | 1.8 |
| Agriculture Labourer | 1986 | 761 | 38.3 | 577 | 75.8 | 55 | 7.2 | 123 | 16.2 | 6 | 0.8 | 634 | 83.3 | 127 | 16.7 | 628 | 82.5 | 129 | 17.0 | 4 | 0.5 |
| Casual Labourer* | 1014 | 315 | 31.1 | 263 | 83.5 | 35 | 11.1 | 17 | 5.4 | 0 | 0.0 | 290 | 92.1 | 25 | 7.9 | 285 | 90.5 | 30 | 9.5 | 0 | 0.0 |
| Shop Keeper | 160 | 35 | 21.9 | 35 | 100.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 35 | 100.0 | 0 | 0.0 | 34 | 97.1 | 1 | 2.9 | 0 | 0.0 |
| Total | 4500 | 2066 | 45.9 | 1530 | 74.1 | 150 | 7.3 | 361 | 17.5 | 25 | 1.2 | 1690 | 81.8 | 376 | 18.2 | 1656 | 80.2 | 389 | 18.8 | 21 | 1.0 |
| Economic Status | |||||||||||||||||||||
| Upper Class | 92 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
| Upper Middle Class | 142 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
| Middle Class | 625 | 320 | 51.2 | 300 | 93.8 | 15 | 4.7 | 4 | 1.3 | 1 | 0.3 | 314 | 98.1 | 6 | 1.9 | 309 | 96.6 | 10 | 3.1 | 1 | 0.3 |
| Lower Middle Class | 1219 | 1415 | 116.1 | 990 | 70.0 | 110 | 7.8 | 301 | 21.3 | 14 | 1.0 | 1106 | 78.2 | 309 | 21.8 | 1088 | 76.9 | 315 | 22.3 | 12 | 0.8 |
| Lower Class | 2422 | 331 | 13.7 | 240 | 72.5 | 25 | 7.6 | 56 | 16.9 | 10 | 3.0 | 270 | 81.6 | 61 | 18.4 | 259 | 78.2 | 64 | 19.3 | 8 | 2.4 |
| Total | 4500 | 2066 | 45.9 | 1530 | 74.1 | 150 | 7.3 | 361 | 17.5 | 25 | 1.2 | 1690 | 81.8 | 376 | 18.2 | 1656 | 80.2 | 389 | 18.8 | 21 | 1.0 |
| Parity | |||||||||||||||||||||
| P 0 | 690 | 218 | 31.6 | 134 | 61.5 | 35 | 16.1 | 47 | 21.6 | 2 | 0.9 | 168 | 77.1 | 50 | 22.9 | 162 | 74.3 | 54 | 24.8 | 2 | 0.9 |
| P 1- P2 | 2341 | 1126 | 48.1 | 844 | 75.0 | 75 | 6.7 | 189 | 16.8 | 18 | 1.6 | 930 | 82.6 | 196 | 17.4 | 910 | 80.8 | 201 | 17.9 | 15 | 1.3 |
| >P3 | 1469 | 722 | 49.1 | 552 | 76.5 | 40 | 5.5 | 125 | 17.3 | 5 | 0.7 | 592 | 82.0 | 130 | 18.0 | 584 | 80.9 | 134 | 18.6 | 4 | 0.6 |
| Total | 4500 | 2066 | 45.9 | 1530 | 74.1 | 150 | 7.3 | 361 | 17.5 | 25 | 1.2 | 1690 | 81.8 | 376 | 18.2 | 1656 | 80.2 | 389 | 18.8 | 21 | 1.0 |
*Small Scale, (Food, Shoes making, Bamboo items) Industry, Welding Workshop, Brick furnace
Table III: Sexual Violence against Elderly Women at Home during COVID-19 Pandemic
| Variables | TTotal | Sexual Violence | Marital sexual violence** | Person *** | ||||
| Age (Years) | Yes | % | Timing | If, Yes *** | ||||
| Sleeping only time | % | Others | % | |||||
| ≥50-≤59 | 2123 | 17 | 0.8 | 17 | 100.0 | 17 | 100.0 | |
| ≥60-≤69 | 1565 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
| ≥70 | 812 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
| Total | 4500 | 17 | 0.4 | 17 | 100.0 | 17 | 100.0 | |
| Education | ||||||||
| Illiterate | 1495 | 10 | 0.7 | 10 | 100.0 | 10 | 100.0 | |
| Primary | 1818 | 7 | 0.4 | 7 | 100.0 | 7 | 100.0 | |
| Secondary/Higher Secondary | 997 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
| Graduate | 190 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
| Total | 4500 | 17 | 0.4 | 17 | 100.0 | 17 | 100.0 | |
| Profession | ||||||||
| Home Maker | 1340 | 10 | 0.7 | 10 | 100.0 | 10 | 100.0 | |
| Agriculture Laborer | 1986 | 5 | 0.3 | 5 | 100.0 | 5 | 100.0 | |
| Casual Laborer* | 1014 | 2 | 0.2 | 2 | 100.0 | 2 | 100.0 | |
| Shop Keeper | 160 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
| Total | 4500 | 17 | 0.4 | 17 | 100.0 | 17 | 100.0 | |
| Economic Status | ||||||||
| Upper Class | 92 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
| Upper Middle Class | 142 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
| Middle Class | 625 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
| Lower Middle Class | 1219 | 3 | 0.2 | 3 | 100.0 | 3 | 100.0 | |
| Lower Class | 2422 | 14 | 0.6 | 14 | 100.0 | 14 | 100.0 | |
| Total | 4500 | 17 | 0.4 | 17 | 100.0 | 17 | 100.0 | |
| Parity | ||||||||
| P 0 | 690 | 2 | 0.3 | 2 | 100.0 | 2 | 100.0 | |
| P 1- P 2 | 2341 | 15 | 0.6 | 15 | 100.0 | 15 | 100.0 | |
| >P3 | 1469 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
| Total | 4500 | 17 | 0.4 | 17 | 100.0 | 17 | 100.0 | |
*Small Scale, (Food, Shoes making, Bamboo items) Industry, Welding Workshop, Brick furnace
** Only sleeping time
*** No relative was responsible
Table IV: Action taken by Elderly Women against Physical and Sexual Violence
| Variables | Total | Informed Someone | Health Care Sought | ||||||||||||||
| Age (Years) | Yes | % | Family Member | % | Police | % | Other | % | Yes | % | *SC /**PHC | % | ***SDH / ****DH | % | Others | % | |
| ≥50-≤59 | 2123 | 957 | 45.1 | 868 | 90.7 | 79 | 8.3 | 10 | 1.0 | 947 | 99.0 | 610 | 64.4 | 260 | 27.5 | 77 | 8.1 |
| ≥60-≤69 | 1565 | 608 | 38.8 | 556 | 91.4 | 45 | 7.4 | 7 | 1.2 | 598 | 98.4 | 458 | 76.6 | 98 | 16.4 | 42 | 7.0 |
| ≥70 | 812 | 518 | 63.8 | 495 | 95.6 | 21 | 4.1 | 2 | 0.4 | 508 | 98.1 | 254 | 50.0 | 248 | 48.8 | 6 | 1.2 |
| Total | 4500 | 2083 | 46.3 | 1919 | 92.1 | 145 | 7.0 | 19 | 0.9 | 2053 | 98.6 | 1322 | 64.4 | 606 | 29.5 | 125 | 6.1 |
| Education | |||||||||||||||||
| Illiterate | 1495 | 771 | 51.6 | 702 | 91.1 | 54 | 7.0 | 15 | 1.9 | 761 | 98.7 | 576 | 75.7 | 150 | 19.7 | 35 | 4.6 |
| Primary | 1818 | 1043 | 57.4 | 970 | 93.0 | 70 | 6.7 | 3 | 0.3 | 1033 | 99.0 | 625 | 60.5 | 346 | 33.5 | 62 | 6.0 |
| Secondary / Higher Secondary | 997 | 259 | 26.0 | 237 | 91.5 | 21 | 8.1 | 1 | 0.4 | 249 | 96.1 | 116 | 46.6 | 105 | 42.2 | 28 | 11.2 |
| Graduate | 190 | 10 | 5.3 | 10 | 100.0 | 0 | 0.0 | 0 | 0.0 | 10 | 100.0 | 5 | 50.0 | 5 | 50.0 | 0 | 0.0 |
| Total | 4500 | 2083 | 46.3 | 1919 | 92.1 | 145 | 7.0 | 19 | 0.9 | 2053 | 98.6 | 1322 | 64.4 | 606 | 29.5 | 125 | 6.1 |
| Profession | |||||||||||||||||
| Home Maker | 1340 | 965 | 72.0 | 892 | 92.4 | 58 | 6.0 | 15 | 1.6 | 955 | 99.0 | 652 | 68.3 | 248 | 26.0 | 55 | 5.8 |
| Agriculture Laborer | 1986 | 766 | 38.6 | 708 | 92.4 | 54 | 7.0 | 4 | 0.5 | 756 | 98.7 | 391 | 51.7 | 295 | 39.0 | 70 | 9.3 |
| Casual Laborer* | 1014 | 317 | 31.3 | 284 | 89.6 | 33 | 10.4 | 0 | 0.0 | 312 | 98.4 | 254 | 81.4 | 58 | 18.6 | 0 | 0.0 |
| Shop Keeper | 160 | 35 | 21.9 | 35 | 100.0 | 0 | 0.0 | 0 | 0.0 | 30 | 85.7 | 25 | 83.3 | 5 | 16.7 | 0 | 0.0 |
| Total | 4500 | 2083 | 46.3 | 1919 | 92.1 | 145 | 7.0 | 19 | 0.9 | 2053 | 98.6 | 1322 | 64.4 | 606 | 29.5 | 125 | 6.1 |
| Economic Status | |||||||||||||||||
| Upper Class | 92 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
| Upper Middle Class | 142 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
| Middle Class | 625 | 320 | 51.2 | 306 | 95.6 | 14 | 4.4 | 0 | 0.0 | 310 | 96.9 | 226 | 72.9 | 56 | 18.1 | 28 | 9.0 |
| Lower Middle Class | 1219 | 1418 | 116.3 | 1296 | 91.4 | 108 | 7.6 | 14 | 1.0 | 1408 | 99.3 | 1199 | 85.2 | 152 | 10.8 | 57 | 4.0 |
| Lower Class | 2422 | 345 | 14.2 | 317 | 91.9 | 23 | 6.7 | 5 | 1.4 | 335 | 97.1 | -103 | -30.7 | 398 | 118.8 | 40 | 11.9 |
| Total | 4500 | 2083 | 46.3 | 1919 | 92.1 | 145 | 7.0 | 19 | 0.9 | 2053 | 98.6 | 1322 | 64.4 | 606 | 29.5 | 125 | 6.1 |
| Parity | |||||||||||||||||
| P 0 | 690 | 220 | 31.9 | 188 | 85.5 | 31 | 14.1 | 1 | 0.5 | 210 | 95.5 | 135 | 64.3 | 45 | 21.4 | 30 | 14.3 |
| P 1- P 2 | 2341 | 1141 | 48.7 | 1053 | 92.3 | 74 | 6.5 | 14 | 1.2 | 1131 | 99.1 | 775 | 68.5 | 300 | 26.5 | 56 | 5.0 |
| >P3 | 1469 | 722 | 49.1 | 678 | 93.9 | 40 | 5.5 | 4 | 0.6 | 712 | 98.6 | 450 | 63.2 | 223 | 31.3 | 39 | 5.5 |
| Total | 4500 | 2083 | 46.3 | 1919 | 92.1 | 145 | 7.0 | 19 | 0.9 | 2053 | 98.6 | 1360 | 66.2 | 568 | 27.7 | 125 | 6.1 |
*Small Scale, (Food, Shoes making, Bamboo items) Industry, Welding Workshop, Brick furnace
*SC – Subcentre **PHC – Primary Health Care
****DH – District Hospital ***SDH – Sub District Hospital
Overall, in the present study of 4500 women interviewed, almost everyone reported change in their lives during the COVID-19 pandemic, either in meals, work, or health care. Of all, 45.9% of women suffered PV at home with the majority (74.1%) by their husbands and 0.4% of women suffered SV all by persons other than their husbands. A significant relation was reported with age, low education, occupation, and low economic class of women who suffered PV and SV at home during the pandemic (p < 0.05). Furthermore, of all the women who suffered PV and /or SV, only 7.0% informed the police. The majority of the women informed their family members about the PV and SV faced at home (92.1%). Furthermore, of all the women who suffered PV and or SC, 98.6% sought healthcare from SC/PHC/SDH/DH/private dispensaries or clinics.
Elder abuse is a critical public health issue with far-reaching social, economic, and health consequences. Before the COVID-19 pandemic, one in ten older Americans experienced elder abuse annually. According to the World Health Organization, elder abuse involves a single or repeated act or a failure to act within a trusted relationship that results in harm or distress to an older adult. [9, 10] The pandemic exacerbated these challenges, with studies highlighting significant declines in both physical and mental health among older women. A survey of 40,821 elderly women in England, with an average age of 76, found that 28 % reported a decline in physical health, while 26 % experienced worsening mental health during the pandemic. [11] Another longitudinal study involving 5,146 women in England revealed a sharp increase in mental health issues, with clinically significant depressive symptoms rising from 12.5 % before the pandemic to 28.5 % during it. This surge was accompanied by increased loneliness, diminished quality of life, and higher anxiety levels, with prevalence growing from 9.4 % to 10.9 % . Widows were particularly vulnerable to negative mental health impacts. [12]
The present community-based study explored the hardships faced by rural elderly women in a remote region during the COVID-19 pandemic. Elderly women aged 50-59, with low education levels, employed as agricultural laborers, having one or two children, and belonging to low socioeconomic backgrounds, were most affected by changes in home environments, work, and meals. These women also reported high rates of PV from husbands and relatives. Among 4500 women interviewed, 45.9 % experienced primarily through slapping, hitting, or kicking with 74.1 % of incidents involving their husbands. Additionally, 0.4 % suffered SV. Many informed family members about these incidents, but only 7.0 % of the victims who suffered PV/SV reported the abuse to the police. However, 98.6 % of PV and SV affected women sought healthcare from primary and secondary healthcare facilities or private clinics.
A study from India echoed these findings, highlighting how older adults, particularly women, faced abuse during the pandemic due to fears of infection, financial strain, and caregiver neglect. Tragically, much of this abuse came from family members, neighbors, and caregivers [1,3]. Similarly, research in Northern Thailand’s hilly tribal communities revealed that elderly women, especially those with limited education and poor economic backgrounds, struggled significantly during the pandemic.[14]
In Malaysia, beyond the direct morbidity and mortality from COVID-19, older adults suffered due to lockdowns, movement restrictions, economic shutdowns, and disruptions to non-essential services. Elderly women were particularly vulnerable to social isolation, compounded by chronic diseases, physical limitations, caregiver dependency, and institutionalization.[15]
A cross-sectional survey in Sweden during the pandemic’s early phase showed that elderly women were at higher risk of mental health issues. Half of the participants reported staying home constantly, and many felt depressed, struggled with sleep, and suffered from isolation. While elderly individuals generally adhered to social distancing recommendations, this compliance risked deteriorating mental health and potential long-term effects. [16]
Another study which focused on immigrants of aged 60 and older from Cuba, the Dominican Republic, El Salvador, Mexico, Puerto Rico, and Venezuela revealed that respondents endured unemployment, hunger, and income loss. [17] The present study in remote villages reflected even higher rates of hardship, with PV and SV being alarmingly common and healthcare access significantly disrupted.
The findings underscore the need for targeted interventions to support older adults, particularly rural and marginalized women, by enhancing healthcare access, promoting safety, and addressing mental health needs during and beyond public health crises.
This community-based study highlights the profound impact of the COVID-19 pandemic on rural elderly women in India. The pandemic disrupted everyday life, with 45.9% of elderly women experiencing increased primarily at the hands of their husbands and 0.4% SV. While the majority of the victims confided in family members, only a small fraction (7.0%) reported incidents to the police.
Key demographic factors such as age, education, occupation, and socioeconomic status significantly influenced the prevalence of abuse. These findings emphasize the need for increased awareness and the development of robust support systems and protective measures for elderly women during public health crises. Establishing clear reporting channels, promoting community-based support, and enforcing legal protections are critical to safeguarding vulnerable populations in future emergencies.
There was only a little honorarium for research assistant.
Authors have no conflicts of interest to disclose.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
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This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
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I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
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Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
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My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
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Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
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Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
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Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
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Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
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