Abstract
Economic abuse (EA) comprises behaviors that impact an individual’s ability to acquire, use, or maintain economic resources, threatening their financial security and well-being. While research on EA has increased in the last two decades, most studies have been conducted in high-income countries with little evidence on how EA manifests in different sociocultural contexts. This mixed-methods scoping review provides an overview of the state of knowledge on EA among adults in low- and middle-income countries (LMICs), focusing on the conceptualization and measurement of EA, including culturally specific forms of EA, and outlining risk factors and consequences of EA to guide future research, policy, and program development. We searched for eligible studies in the ProQuest Social Science Collection, APA PsycINFO, Web of Science, and Medline and identified 30 studies across 20 LMICs published in English up to May 2024. Culturally specific forms of EA in LMICs that emerged from this review included refusal to contribute financial resources, restricting access to shared housing, bride price and dowry-related tactics, and exploitation of women’s labor. Findings also highlighted the role of sociocultural norms in shaping the kinds of EA women faced. Gendered norms around women’s and men’s economic roles, including customary marriage practices and patrilocality, emerged as the main risk factors. Several studies found linkages between EA and poor mental and physical health and financial hardship. EA also often co-occurred with other forms of abuse. Studies highlighted the need for gender-egalitarian legislation, increasing awareness of EA, survivors’ knowledge of financial practices, culturally sensitive interventions, and longitudinal research.
Introduction
Economic abuse (EA) is a lesser-known form of abuse used to threaten a survivor’s financial stability to keep them dependent on their abuser. It includes behaviors that impact an individual’s ability to acquire, use, or maintain economic resources, threatening their financial security and well-being (Adams et al., 2008). EA has three overarching categories: economic restriction, exploitation, and education and employment sabotage. Economic restriction includes refusing to provide money, food, and other essentials; forcing a partner to ask for money; monitoring a partner’s expenses; and hiding and denying access to financial information to limit a partner’s economic resources. Economic exploitation includes tactics to forcibly or fraudulently use a survivor’s financial resources for their benefit (Adams et al., 2020; Stylianou, 2018). This can include behaviors such as stealing, gambling, using joint money, creating debt in the intimate partner’s name, and intentionally harming a partner’s financial resources and credit history (Johnson et al., 2022; Stylianou, 2018). Employment and education sabotage encompasses behaviors that prevent survivors from working or obtaining education or training, harassing them at their workplace, and preventing them from creating financial assets (Postmus et al., 2016; Yount et al., 2021).
EA can have a devastating impact on a survivor’s health and financial security by limiting their access to economic opportunities, assets, and long-term financial capabilities. Experiences of EA have been associated with increased material and financial hardship in the form of lower educational attainment, earnings, housing instability, material hardship, and coerced debt (Adams et al., 2013; Johnson, 2021; Voth Schrag et al., 2020). EA limits survivors’ access to economic resources and increases their financial dependence on their partners, making it harder for them to leave abusive relationships (Heron et al., 2022; Voth Schrag et al., 2019). In addition to financial well-being, EA also has adverse impacts on health. Studies have established a link between EA and depression and post-traumatic stress symptomology (Postmus et al., 2012; Voth Schrag, 2014; Voth Schrag et al., 2019). While these studies highlight the harmful effects of EA, they have primarily been conducted in the US, and there is a lack of information on the manifestations and impact of EA in low- and middle-income countries (LMICs).
In addition to descriptive research, measurement research on EA has been primarily conducted in high-income countries (HICs). Adams et al. (2008) developed the first comprehensive measure of EA, the Scale of Economic Abuse (SEA), in the US (Adams et al., 2008) to capture two dimensions of EA: economic control and economic exploitation. Eight years later, Postmus and colleagues revised the SEA (Postmus et al., 2016), adding a new subscale of employment sabotage (SEA12). More recently, Adams and colleagues revised the SEA to create a shorter form of the scale, the SEA2. The subscale for “economic control” was renamed “economic restriction,” recognizing that economic control is a form of abuse (Adams et al., 2020). These three widely used measures of EA were tested in the US with a sample of low-income women who were accessing services for domestic violence (Johnson et al., 2022).
Conversely, the Economic Coercion Scale (ECS-36) is the only measure developed and tested in an LMIC, Bangladesh (Yount et al., 2021). It has two subscales assessing barriers to acquiring economic resources and interference with using or maintaining them (Yount et al., 2021). The two dimensions of EA in the ECS-36 overlap with those identified in SEA, SEA12, and SEA2. The main distinction is that the ECS-36 does not include tactics to damage consumer credit or hide investments, as they are not relevant for rural Bangladesh, where the measure was tested, highlighting the importance of creating culturally sensitive measures.
Current Study
To date, three reviews of research on EA have been conducted; all three emphasized the need for more research on EA in LMICs (Johnson et al., 2022; Postmus et al., 2020; Yau et al., 2021). These global reviews focused on the conceptualization and measurement of EA (Postmus et al., 2020), the measurement and impact of EA on mental health (Yau et al., 2021), and the impact of EA on survivors (Johnson et al., 2022). Existing reviews have stressed the importance of understanding how different cultural norms shape individual experiences of EA, its impact on survivors, and their help-seeking behaviors. For example, cultural marriage practices such as dowry can be used to exploit women in South Asian communities (Anitha, 2019; Chowbey, 2017; Steinert et al., 2023). In their review, Yau et al. (2021) also note the need to assess the relevance of existing measures of EA, most of which were developed in the US, for different sociocultural settings to gain a more nuanced understanding of the scope of EA outside of the US. While past reviews have highlighted the nature of EA and its impact, to the best of the authors’ knowledge, no studies have yet focused on the role of cultural norms in influencing women’s experiences of EA in LMICs or identified its risk factors. The current review addresses this gap by providing an overview of the state of knowledge on EA in LMICs, focusing on the conceptualization and measurement of EA and documenting risk factors and consequences of EA.
Methods
The three main questions that guided this review are: (a) how have researchers defined and conceptualized EA in LMICs, including culturally specific forms of EA? (2) how have researchers measured EA in LMICs? and (c) what are the risk factors and consequences of EA in LMICs? After finalizing the research questions, we registered a protocol for a scoping review in March 2024. We followed Arksey and O’Malley’s (2005) framework for conducting scoping reviews along with updated guidance (Levac et al., 2010). Databases included the ProQuest Social Science Collection (including ProQuest Sociology collection, Social Science database, Criminal Justice database), APA PsycINFO, Web of Science, and Medline. Search terms included keywords for EA (“economic abuse” OR “financial abuse” OR “economic violence” OR “coerced debt” OR “economic control” OR “employment sabotage” OR “economic exploitation” OR “financial exploitation” OR “financial control” OR “financial conflict” OR “economic conflict”) AND terminology for IPV (“intimate partner violence” OR “intimate partner abuse” OR “domestic violence” OR “domestic abuse” OR “dating violence” OR “battered women” OR “gender-based violence”). We used Covidence to organize and screen documents for this review. The inclusion criteria were: (a) EA experience is the focus of the study, (b) research is conducted in LMICs, (c) EA is experienced in intimate relationships, excluding studies that investigated EA in the context of elder abuse, and (d) full-text publication available in English. There was no limit to the year the study was published, as this is a growing field of research, but the end date was May 2024. We used the World Bank’s (2023) classification for country and lending groups to identify LMICs.
Eligibility Criteria
Our search yielded 378 research articles on EA. After removing duplicates, 173 unique studies on EA were available for our review. Two authors screened the articles in the first step and had a 92% agreement rate for the initial screening process. They resolved discrepancies based on a discussion of the methodology of the studies. Out of these 173 studies, 137 studies were excluded because they were conducted in HICs (n = 124), were review papers (n = 4), or focused on EA in the context of elder abuse (n = 9). The first author screened the full text of the articles to further establish eligibility. Out of the 36 eligible studies, three were excluded due to their sole focus on the perpetration of EA rather than the experience of EA, and a further three articles were excluded as they focused on EA in the context of elder abuse. The PRISMA flowchart documents the review process in Figure 1. At the end of the selection process, 30 studies were retained for the review.
PRISMA flowchart of the study selection process for inclusion in the scoping review.
Data Extraction and Analysis
In the first step, we extracted data from the 30 eligible studies using a tabular format and used grouping techniques to identify key themes. We did not use a critical appraisal tool as this is a conceptual scoping review, and studies had varied research designs and aims. We included qualitative and quantitative studies to answer our research questions. Qualitative studies discussed EA’s conceptual underpinnings, allowing us to identify the different constructs of EA in LMICs. On the other hand, quantitative studies examined the magnitude of associations between EA and various risk factors and consequences.
Results
For this study, we reviewed 30 articles, including 21 quantitative and nine qualitative studies. Table 1 presents the descriptive characteristics of the included quantitative studies, and Table 2 details the findings from the qualitative studies. After describing the studies in our review, we will outline our findings in line with the three research questions that guided this study (Table 3).
Study Characteristics, Measurement of Economic Abuse, and Key Findings From Quantitative Studies in LMICs.
Note. IPV = intimate partner violence; LMICs = low and middle-income countries; EA = economic abuse; SEA = scale of economic abuse.
Study Characteristics, Measurement of Economic Abuse and Key Findings From Qualitative Studies in LMICs.
Note. IPV = intimate partner violence; LMICs = low and middle-income countries; EA = economic abuse.
Table 3. Critical Findings.
Note. LMICs = low and middle-income countries; EA = economic abuse.
Study Characteristics
Most of the 30 studies were conducted in Asia (see Figure 2), followed by Africa, the Middle East, and a single study in South America. All studies used cross-sectional data.
Location of studies included in the scoping review.
Samples
There was a difference in the samples employed in quantitative and qualitative studies. Most quantitative studies recruited women from households in the general population (n = 16 out of 21). In contrast, most qualitative studies included samples of women who had experienced EA or any other form of abuse. Less than half of the qualitative studies (n = 4) included samples of women recruited from organizations or individuals providing support services to women experiencing abuse. All studies employed a purposive sample, with one exception of a theoretical sample (Chowbey, 2017), and five out of nine studies recruited women who had experienced abuse.
Experience of EA
Studies used different designs and measures to assess EA, making it difficult to compare across contexts. Women’s experience of EA ranged from roughly one in three women (27% in Turkey) to nearly two in three women (63% in rural Bangladesh and 64% in Nigeria). In studies with purposive sampling, prevalence rates were higher, ranging from 85% among substance-use-involved women in Kyrgyzstan to 93% among sex-working women in Uganda.
Among the 21 quantitative studies that reported frequencies for types of EA, the most common forms of EA differed across sociocultural contexts. Across countries, the most prevalent form of EA was economic restriction. Within economic restrictions, women were most likely to have financial information withheld, followed by the need to account for expenditures. There was some regional variation. Employment sabotage was the most reported tactic in five Asian studies, while refusal to contribute was the most prevalent form of EA in Africa.
RQ1: Defining and Conceptualizing Economic Abuse
We used thematic analysis to categorize the tactics described in each text’s introduction and literature review sections. Almost all studies clearly defined EA using the definition outlined by Adams et al. on the SEA (Adams et al., 2008). Most tactics could be categorized into the three primary constructs of EA: economic restriction, economic exploitation, and employment/education sabotage. A single study described only one tactic of EA: economic exploitation (Asencios-Gonzalez et al., 2018), which was also its focus and another did not specify the tactics of EA (Gibbs et al., 2020).
Culturally Specific Forms of EA
Of 21 studies, 10 highlighted culturally specific forms of EA corresponding to social norms and customary practices in LMICs. Most of these studies used qualitative methodology. Several quantitative studies used measures developed in the US, and their findings were limited to the tactics of EA included in these measures.
Refusal to Contribute and Other Forms of Economic Exploitation
The most common culturally specific form of EA in LMICs is the refusal to contribute to household expenditures. This tactic has been conceptualized differently in different contexts. In Bangladesh, it was termed “economic neglect,” “chronic economic dependency” in Ghana, and “male irresponsibility” in Tanzania. Refusal to contribute includes tactics where husbands and marital family members did not contribute or contributed very little to fulfilling basic household necessities such as food, shelter (Boateng & Tenkorang, 2023; Frost et al., 2023; Serpa Pimentel et al., 2021; Steinert et al., 2023) or healthcare, and children’s and women’s needs (Chowbey, 2017; Steinert et al., 2023). Women were forced to use their earnings or get a job solely to provide for necessities. While this form of economic refusal was more common among women participating in income-generating activities (Miedema et al., 2021; Sedziafa et al., 2016), this tactic was not limited to them. Women who were financially dependent on their spouses also experienced this kind of neglect (Chowbey, 2017; Jiwatram-Negron et al., 2018; Steinert et al., 2023).
Social norms influenced women’s perception of this kind of abuse. In one study, this form of economic exploitation was seen as “male economic irresponsibility” as women identified this behavior as abuse owing to their male partners’ inability to fulfill normative expectations of men being the primary economic providers (Serpa Pimentel et al., 2021). The custom of patrilocality, where women move to their husbands’ or marital families’ homes after marriage in South Asia, also makes women vulnerable to economic neglect and exploitation (Chowbey, 2017; Steinert et al., 2023).
Studies also highlighted the related dimension of chronic economic dependency among partners of earning women, adversely impacting women’s economic self-sufficiency (Sedziafa et al., 2016). In addition to not providing for household necessities, men would not work or spend income on alcohol or gambling and leave women to seek assistance from their families and friends (Serpa Pimentel et al., 2021; Sedziafa et al., 2016; Steinert et al., 2023). Even when women and men were earning and contributing toward household expenditures and mortgages, men were more likely to purchase durable items in their names, creating assets they could retain if the relationship ended (Usta et al., 2013). In contrast, women spent their income on household necessities and their children’s needs, exacerbating their economic vulnerability (Sedziafa et al., 2016; Usta et al., 2013). Women often went along with these financial arrangements and spent their income or sought assistance for their relationship and family’s long-term benefit and then felt cheated when their husbands ended the relationship after economically exploiting them (Sedziafa et al., 2016).
Curtailing Access to Resources
Studies identified two other modes of economic restriction. South Asian women in transnational marriages were not granted any access to transnational investments that their husbands made. Such investments did not come under the scrutiny of local laws, and survivors could not use legal mechanisms to access these shared assets (Chowbey, 2017). Another tactic was restricting women’s right to shared housing. This included denying women their right to property in India (Kanougiya et al., 2021) and threatening and throwing women out of the house in Nigeria and Ghana (Nduka et al., 2023; Sedziafa et al., 2016). Women rarely had ownership rights to shared marital property, making them vulnerable to this form of economic restriction.
Dowry and Bride Price
Three studies from India described dowry-related tactics of EA (Anitha, 2019; Chowbey, 2017; Steinert et al., 2023). These tactics included forcibly controlling and limiting access to assets received as dowry (economic restriction), selling these assets, or using these assets as collateral for loans without the woman’s consent (economic exploitation). Dowry-related harassment can continue after marriage, with the groom’s family demanding more payments and assets from the bride’s family (Anitha, 2019; Chowbey, 2017; Usta et al., 2013). While these tactics are culturally prevalent in South Asia, a single study from Turkey also described similar tactics of forced appropriation of women’s wedding jewelry and demands for a dowry or bride price (Alkan et al., 2021). The custom of bride price, like dowry, involves a reverse transfer from the groom to the bride’s family and also leads to EA. Sedziafa et al. (2016) describes how, in Ghana, bride price may symbolize a “loss” or “transfer” of the woman’s rights, including her economic rights. Husbands could claim complete ownership of their wives’ assets and rights owing to the bride’s price being paid at the wedding (Boateng & Tenkorang, 2023; Sedziafa et al., 2016).
Control Over Women’s Labor
Two other tactics of EA were unique to the LMIC context. The first is the coercive control of women’s labor in transnational marriages, another form of women’s economic exploitation. Husbands and other members of the marital family forced women to work in family businesses, take up jobs, or perform domestic tasks without compensating them for their labor or giving them any access to their earnings. This complete lack of access to earnings is a distinct form of economic exploitation. In some cases, women were also not provided any medical help when they fell sick after being overworked (Anitha, 2019).
RQ2: Measuring Economic Abuse
Our review included 21 quantitative studies that used a variety of instruments to measure EA. Most studies (n = 9) used a set of items to measure EA, and these items were often taken from validated measures such as the ECS-36 (Yount et al., 2021), the SEA2 (Adams et al., 2020), or the SEA12 (Postmus et al., 2016). The number of items authors used varied considerably, ranging from 15 in India (Kanougiya et al., 2021) to three in Vietnam (Yount et al., 2016). Although studies used items from other measures, most items corresponded to EA dimensions, including economic restriction, employment and education sabotage, and economic exploitation.
Three studies focused on developing a new measure of EA in Bangladesh (Yount et al., 2021) or validated a measure of EA developed in the US for Iran (Salimi et al., 2023) and China (Yau et al., 2019). Both studies reported positive results after modifying certain items for the local context. For example, the item “Make you ask him for money” was removed in Iran as it was not viewed as EA. Men control finances, and asking them for money is standard practice (Salimi et al., 2023). Four studies used measures validated in the US. Three provided information on reliability but did not provide any other information on the psychometric properties of these measures in the context they were being tested (Alsawalqa Rula, 2020; Jennings Mayo-Wilson et al., 2023; Jiwatram-Negrón et al., 2018; Nduka et al., 2023).
Timeframe of Measurement
Studies differed in the recall period used to measure the experience of EA. Out of the 20 quantitative studies, most (n = 11) asked respondents to report lifetime experiences of EA, and five asked about experiences in the past year (Gibbs et al., 2018; Nduka et al., 2023; Yau et al., 2019, 2020; Yount et al., 2021). Three studies did not specify the recall period for their measures (Li et al., 2024; Ohlan, 2021; Tenkorang & Owusu, 2018). In two studies, women were asked to report their experiences of EA during the duration of their relationship (Jennings Mayo-Wilson et al., 2023; Salimi et al., 2023).
RQ3: Risk Factors of EA
Across the included studies, traditional gender norms emerged as one of the most dominant drivers of EA in quantitative and qualitative studies (Serpa Pimentel et al., 2021; Sedziafa et al., 2016; Usta et al., 2013). Some of the risk factors related to traditional norms and customary practices of patrilocality, bride price, and dowry have been discussed in the previous section. Studies also highlighted the role of “male backlash.” Women’s EA experiences are influenced by their participation in income-generating activities (Miedema et al., 2021). This participation may be perceived as a threat to ideals of masculinity and men’s economic dominance, and men may resort to violence in response (Serpa Pimentel et al., 2021; Sedziafa et al., 2016). Women with remunerated work had significantly higher odds of experiencing EA than women not participating in the labor force (Kanougiya et al., 2021; Miedema et al., 2021). Second, social norms influence women’s access to financial decision-making and control over joint/familial financial resources. Men often assume that only those who earn or contribute to the family can access finances and decide on their use (Usta et al., 2013). Third, as women are traditionally assigned caregiving roles within the family, it is also commonly assumed that they lack financial literacy and knowledge and should not be involved in household financial matters (Serpa Pimentel et al., 2021).
Beyond sociocultural factors, several studies examined the associations between socioeconomic factors and EA. The role of education was ambiguous. While some studies reported a higher risk of experiencing EA for women with higher education levels (Alkan et al., 2021; Yau et al., 2020; Yount et al., 2016), others found that higher education was protective (Alsawalqa, 2020; Antai et al., 2014; Asencios-Gonzales et al., 2018) or had no significant impact (Mayo-Wilson et al., 2023). More importantly, educational disparities between spouses or partners may be more pertinent in determining the likelihood of EA than women’s overall education status. This is supported by findings from Bangladesh, where women with fewer years of schooling relative to their husbands had a higher risk of experiencing co-occurring EA and other forms of IPV (Yount et al., 2016). Similarly, in Turkey, women with higher education faced more EA, but the likelihood decreased significantly if their male partners also had higher education levels (Alkan et al., 2021).
Several quantitative (Asencios-Gonzales et al., 2018; Mayo-Wilson et al., 2023; Yount et al., 2016) and qualitative (Frost et al., 2023; Usta et al., 2013) studies found associations between women’s lack of income, poverty, and a higher risk of EA. Qualitative studies suggest that women may be economically dependent on their partners, which may trap them in abusive relationships and force them to tolerate their partner’s violent behaviors, including EA (Sedziafa et al., 2016).
Apart from this, studies reported significantly higher levels of EA among women with children or women who were currently pregnant in quantitative (Alkan et al., 2021; Asencios-Gonzales et al., 2018; Jiwatram-Negron et al., 2018) and qualitative studies (Frost et al., 2023). Associations between women’s marital status and EA were also inconsistent across quantitative studies, with some reporting a higher risk among unmarried women (Kanougiya et al., 2021; Yau et al., 2020) and others indicating the opposite trend (Alkan et al., 2021; Alsawalqa, 2020; Mayo-Wilson et al., 2023). Cohabiting with their partners was associated with an increased risk in quantitative (Asencios-Gonzales et al., 2018; Yau et al., 2020) and qualitative studies (Frost et al., 2023).
Several studies identified possible correlates of EA that resembled the risk factors commonly highlighted by epidemiological studies on IPV. These included partner’s alcohol or drug consumption (Alkan et al., 2021; Kanougiya et al., 2021), experiencing other forms of abuse (Nduka et al., 2023; Kanougiya et al., 2021; Antai et al., 2014; Usta et al., 2013), having witnessed or experienced violence during childhood (Alkan et al., 2021; Yount et al., 2016), poor mental health (Alkan et al., 2021), holding attitudes that endorse or are accepting of violence (Antai et al., 2014).
In qualitative studies, jealousy or extra-marital affairs (Boateng & Tenkorang, 2023; Sedziafa et al., 2016) and substance-use (Boateng & Tenkorang, 2023) emerged as risk factors. Studies also discussed links between legal frameworks and women’s exposure to EA. Discriminatory laws placed women at a disadvantage in terms of (a) property and inheritance rights, (b) the lack of post-divorce alimony provisions, or (c) the regulation of patriarchal oversight in women’s integration into the labor market (Anitha, 2019; Usta et al., 2013).
RQ4: Consequences of EA
In the quantitative studies, the most frequently examined consequence of EA was its impact on mental health. Seven studies found significant associations between EA and adverse mental health. One study reported mixed findings for depression, noting that combined experiences of multiple types of IPV—including physical, sexual, and economic—had the strongest correlation with depressive symptoms (Gibbs et al., 2020). Four other studies examined depression or depressive symptoms, and all found a significant relationship between EA and an increased likelihood of these symptoms (Gibbs et al., 2018; Kanougiya et al., 2021; Postmus et al., 2022; Yau et al., 2020). Similarly, EA was positively associated with suicidal ideation or attempts (Gibbs et al., 2018; Kanougiya et al., 2021), anxiety (Kanougiya et al., 2021; Yau et al., 2020), psychological distress or worse psychosocial health (Tenkorang & Owusu, 2018), and psychosomatic symptoms (Yau et al. 2020). Qualitative studies also noted adverse mental health outcomes reported by survivors of EA, including depression (Serpa Pimentel et al., 2021; Usta et al., 2013), suicidal ideation, stress, and alcohol use (Serpa Pimentel et al., 2021), anxiety and low self-esteem (Usta et al., 2013), isolation (Anitha, 2019), and trauma (Sedziafa et al., 2016).
Other consequences of EA included overall health outcomes, with significant adverse effects on self-reported generalized health quality (Gibbs et al., 2020; Tenkorang & Owusu, 2018) and cardiovascular health (Tenkorang & Owusu, 2018). Mayo-Wilson et al. (2023) also found that among women employed in sex work, sexual risk-taking increased as EA increased, while HIV preventive care-seeking decreased with higher levels of abuse. A few qualitative studies also noted that EA survivors reported chronic ill health (Usta et al., 2013), injuries, and limited access to health care (Sedziafa et al., 2016).
Economic outcomes were investigated quantitatively by a few researchers. Female microentrepreneurs were less likely to receive and use credit for business capital and had more late payments (Asencios-Gonzalez et al., 2018). Both entrepreneurs and sex workers who experienced EA were more likely to seek financial assistance from family members or lending institutions (Mayo-Wilson et al., 2023). A single study found that EA was associated with increased food insecurity, and this relationship was mediated by depression (Postmus et al., 2022). Qualitative studies also found that EA often resulted in adverse economic outcomes, including decreased access to financial assets (Chowbey, 2017); increased unemployment or underemployment, poverty, and use of welfare benefits (Anitha, 2019); sub-standard housing, inadequate food, and employment instability (Usta et al., 2013); and limited women’s economic security, preventing economic independence and employment (Sedziafa et al., 2016). Suggesting the “feminization of poverty within relationships”, Anitha (2019) found that EA resulted in different living standards for survivors within the same household. One study also reported that women managed EA’s impact on their finances, including covertly finding work, education, or training—facing potential physical violence while employing such tactics (Chowbey, 2017).
The qualitative studies included in this review also reported several outcomes of EA which were not examined within the quantitative analyses. First, the concept of dependence was commonly mentioned, with survivors reporting increased dependence on the abusive partner due to a lack of financial assets due to EA (Chowbey, 2017), limiting survivors’ ability to leave such relationships (Serpa Pimentel et al., 2021; Sedziafa et al., 2016; Anitha, 2019; Usta et al., 2013). Likewise, some qualitative studies reported on the impact of EA on survivors’ post-separation outcomes or potential future outcomes, including limits on immigration status (Anitha, 2019), less educational, training, and self-improvement efforts (Usta et al., 2013), and limiting survivors’ entrepreneurial creativity (Sedziafa et al., 2016).
Co-occurring With Other Forms of Abuse
Many of the quantitative studies (n = 11) examined the association between EA and different types of IPV, with all studies reporting a significant association between EA and other kinds of abuse (see Table 4). Specifically, EA was significantly associated with physical violence (n = 10), verbal, emotional, or psychological abuse (n = 10), sexual violence (n = 5), and any IPV (n = 1). Five qualitative studies also described types of IPV co-occurring with EA. EA triggered other forms of IPV, including physical violence (Chowbey, 2017; Steinert et al., 2023) and sexual coercion. In Nigeria, men expected sexual favors from young women in return for any money or food payments (Frost et al., 2023). Male partners coerced women to have sex by threatening to withhold money in Ghana (Sedziafa et al., 2016) and Lebanon (Usta et al., 2013).
Types of Abuse Co-occurring With EA.
Note. EA = economic abuse.
Discussion
Our review provides an overview of the current state of knowledge on EA in LMICs, focusing on the conceptualization and measurement of EA, identifying culturally specific forms of EA, and risk factors and consequences of EA to guide future research, policy, and program development. Our review of 30 studies conducted across 20 countries indicates that the field of EA research in LMICs is growing. Notably, most studies included a clear definition of EA and used consistent terminology to conceptualize EA. Studies also investigated EA as a distinct form of abuse separate from emotional, physical, and sexual abuse, indicating the growing recognition of EA as a unique form of abuse. Overall, research in LMICs focused on the three primary constructs of EA: economic restriction, economic exploitation, and education and employment sabotage, consistent with a global review of EA research (Postmus et al., 2020). Studies also highlighted several culturally specific forms of EA that emphasize the role of sociocultural norms in the kinds of EA women faced. Gendered norms around women’s and men’s economic and social roles, including customary marriage practices, such as dowry and bride price and patrilocality, emerged as culturally specific forms of EA and risk factors in different contexts. These norms also influenced the kinds of legal protection available to women with limited inheritance, property, and divorce rights, exacerbating women’s risk of EA (Anitha, 2019). Sociocultural norms also influenced women’s perceptions of abuse. In Tanzania, a husband’s refusal to contribute to expenses was conceptualized as “irresponsibility” and seen as a form of abuse as it contradicts prevalent social norms where men are the primary providers (Serpa Pimentel et al., 2021). In Bangladesh, women viewed EA as a type of relationship dynamic, and constraints to economic activity were normalized in marriages (Miedema et al., 2021). While several studies highlighted culturally specific forms of EA, all these tactics could be categorized under the three dimensions of EA. The tactic of refusal to contribute was documented as a distinct dimension of EA in two studies (Steinert et al., 2023; Serpa Pimentel et al., 2021). However, it can also be seen as a form of economic exploitation as the husband’s refusal to contribute led to women using their earnings or borrowing, depleting their economic resources.
While formative research on EA has advanced in LMICs, there is a need for more measurement research. Prior reviews have emphasized the need for more research to understand whether existing measures of EA work as well across cultures or whether we need culturally specific measures of EA (Johnson et al., 2022; Yau et al., 2021). Our findings on culturally specific forms of abuse in LMICs also have similar implications for the measurement of EA. While a new measure has been developed in Bangladesh (Yount et al., 2021), and existing measures such as the SEA2 and the SEA12 have been validated in China (Yau et al., 2019) and Iran (Salimi et al., 2023), more research is needed to understand and measure culturally specific forms of EA. For example, studies conducted in India find that marital family members often perpetrate EA alongside husbands (Anitha, 2019; Chowbey, 2017; Steinert et al., 2023), emphasizing the need to use a framework of domestic violence rather than IPV to assess the role of multiple perpetrators when measuring EA. We also need to ensure that the items used in the SEA2 and the SEA12 are valid across all cultural contexts. For example, refusal to contribute is a common form of EA in LMICs that needs to be adequately captured in existing measures of EA (Serpa Pimentel et al., 2021). We also need more rigorous standards for measurement research; several studies used the SEA12 or the SEA2 in a new context and only provided a measure of reliability without including other psychometrics. While reliability is an important criterion, we also need validity estimates to ascertain the quality and meaning of the measure (Jordan et al., 2011). In addition, there is also a need to develop a cross-cultural measure that can be used to estimate and compare the prevalence of EA across contexts, as different studies have used various measures.
Several studies highlighted the cost of EA for survivors. Most studies found evidence of an association between experiences of EA and adverse mental health-related outcomes (Gibbs et al., 2020; Kanougiya et al., 2021; Yau et al., 2020). In addition, most studies assessed the impact of EA alone on mental health outcomes, and we need more studies to evaluate differences in the association between EA alone and EA co-occurring with other forms of abuse to understand the impact of EA above and beyond the effect of different forms of abuse (Johnson et al., 2022). Of the 30 studies in our review, only two examined associations between EA and physical health outcomes, finding a negative relationship (Gibbs et al., 2020; Tenkorang & Owusu, 2018). We need more studies to investigate the impact of EA on a broader range of physical health outcomes. In addition, as Johnson et al. (2022) note, studies should use standardized measures for health outcomes to allow researchers to compare findings across contexts.
Future research should also examine the impact of EA on a broader range of financial outcomes. In our review, qualitative studies were more likely to explore financial outcomes than quantitative studies. Only two quantitative studies investigated the impact of EA on two specific groups of women earners. Sex-working women and microentrepreneurs experiencing EA were more likely to seek financial assistance and experience economic hardship, respectively (Asencios-Gonzalez et al., 2018; Mayo-Wilson et al., 2023). These outcomes were measured using single items and were not validated in previous studies. On the other hand, qualitative studies found linkages between EA and occupational and housing instability, poverty, food insecurity, and an overall reduction in the standard of living (Anitha, 2019; Chowbey, 2017; Usta et al., 2013). Taken together, the findings suggest that EA adversely impacted women’s economic security.
While the findings of this review are not unique to LMICs (Johnson et al., 2022), women in LMICs are particularly vulnerable as they also contend with traditional gender norms and lack of legal entitlements that make it harder for them to access employment, education and their share of marital assets, increasing their financial dependence on their marital families. The stigma around divorce makes women more vulnerable to staying in abusive relationships. More quantitative studies on economic hardship and self-sufficiency are needed to explore this relationship in depth. Research should also include explanatory variables to identify pathways between EA and financial hardship. More research is needed to understand how EA affects women’s economic aspirations and agency. While employment can be empowering, EA may restrict women’s employment opportunities or force them to take up exploitative jobs without advancement opportunities or unfavorable labor conditions that have long-term impacts on their careers and well-being (Usta et al., 2013). It is essential to assess the effect of EA on financial well-being, including economic freedom and agency (Johnson et al., 2022).
Limitations
This review has several limitations. All the studies used a cross-sectional design. Because of this, we cannot draw any conclusions about the directionality of risk factors or consequences of EA. Several studies also did not include essential confounders. Given the high probability of co-occurrence of EA with other forms of abuse, it is hard to isolate the role of EA on any outcomes. Future studies should use longitudinal designs to examine the directionality and pathways between EA and socioeconomic consequences. Our review focused on studies that examined women’s experiences of EA in intimate relationships, and studies on elder abuse were excluded. Future studies should conduct a systematic review of EA experience and perpetration among men and elder abuse, which is an understudied area within EA. The findings from qualitative studies in our review are also not generalizable to the broader population, as most studies sampled women experiencing EA or other forms of abuse. Lastly, our review only included studies published in English, which may have prevented us from including research published in local languages.
Implications
Our review has important implications for future research and practice (see Table 5). First, despite increased research on EA, our evidence is limited to 20 out of 136 countries classified as LMICs. We need to conduct more research on EA in LMICs to broaden our understanding of EA and its linkages with other forms of abuse. Second, only one study examined the role of mediators in the association between EA and an outcome of interest. We need more research with explanatory variables to understand the pathways between EA and outcomes of interest. This will allow researchers to develop an appropriate theory of change for evidence-based interventions and policies. Third, we need to increase the range of outcomes studied as consequences of EA, including financial security and well-being. Studies on EA in HICs have begun to examine the impact of EA on parenting and child development-related outcomes (Johnson et al., 2022), and this research needs to be conducted in LMICs as well. Fourth, we found that EA co-occurs with other forms of abuse, and we need more longitudinal research to understand the sequelae of abuse and the differences in impact from isolated EA versus EA that co-occurs with other forms of abuse. Additional research is needed with more diverse samples, including LGBTQIA+ individuals, men, adolescents, and older adults. Lastly, studies also used different recall periods in their measures of EA. We recommend that researchers ask for both recall periods as the field of EA research is still growing, and we may be able to understand the lifetime trajectory of EA better once we have more studies that have information on both lifetime and past-year experience of EA. Our review has documented the harmful impact of EA on survivors, and we urgently need to develop interventions to prevent EA. Financial planning and safeguarding should be included in all IPV and DV prevention interventions. Poverty, microfinance, and job-training interventions should include gender transformative programming to address patriarchal norms around women’s employment.
Implications of Findings.
Note. IPV = intimate partner violence; LMICs = low and middle-income countries; EA = economic abuse.
Conclusion
This review provides an overview of the current knowledge on EA in LMICs using evidence from 30 qualitative and quantitative studies. Our findings from 20 countries document a high burden of EA among survivors in LMICs. Findings also highlight culturally specific forms of EA linked to sociocultural norms and customary practices. This review also highlights the adverse impact of EA on survivors’ mental and physical health and financial well-being. We emphasize several gaps in the literature and provide suggestions for future research and practice. Key recommendations include the need for longitudinal research on EA in LMICs using validated measures and a wide range of financial outcomes to understand EA’s short- and long-term effects on survivors’ well-being to develop culturally relevant policy and programmatic responses to prevent EA.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
