A Multivariate Statistical Framework for Ranking States and Districts by Spousal Domestic Violence Burden in India: A Secondary Analysis of NFHS-5 Data Using Principal Component Analysis

Background Spousal violence remains a critical public health and human rights concern in India, with serious consequences for women’s physical, emotional, reproductive, and social well-being. It includes emotional, physical, and sexual abuse perpetrated by husbands and is deeply rooted in gender inequality, socio-cultural norms, and structural vulnerabilities. Despite legislative protections and national initiatives to safeguard women, intimate partner violence continues to affect a substantial proportion of ever-married women. Understanding the magnitude, geographic distribution, and combined burden of different forms of spousal violence is essential for identifying high-risk regions and guiding targeted interventions. This study aims to rank Indian states and districts based on the composite burden of emotional, physical, and sexual spousal violence using nationally representative data. Methods This study conducted a secondary analysis of data from the National Family Health Survey-5 (NFHS-5, 2019–21), focusing on ever-married women aged 15–49 years who completed the domestic violence module. State- and district-level prevalence of emotional, physical, and sexual spousal violence was estimated. Principal Component Analysis (PCA) was applied to construct a composite index representing the combined burden of these three forms of violence and to generate state- and district-level rankings. Socio-demographic characteristics were examined to identify patterns of vulnerability across population subgroups. Results Overall, 15.8% of women reported experiencing emotional violence, 35.1% reported physical violence, and 10% reported sexual violence. Greater vulnerability was observed among older women, those with lower educational attainment, and rural residents. Considerable geographic disparities were identified across states and districts. Karnataka exhibited the highest prevalence across all three forms of violence, whereas Lakshadweep showed the lowest prevalence. PCA-based rankings highlighted districts with disproportionately high combined burdens, indicating clusters of heightened vulnerability requiring urgent and focused intervention. Conclusion Substantial state-wise and district-wise disparities in spousal violence persist across India. The findings emphasize the importance of region-specific prevention strategies, strengthened awareness initiatives, and policy interventions tailored to high-burden areas. Addressing socio-economic inequalities and improving institutional support mechanisms are critical for reducing intimate partner violence and promoting women’s overall well-being in India.