Association of husband’s controlling behavior and intimate partner violence in Nepal: a comparative analysis of Nepal demographic and health surveys 2016 and 2022

Intimate partner violence (IPV) remains a significant public health concern in Nepal. This study examines the association between husband’s controlling behavior and the lifetime prevalence of IPV among ever-married women, comparing data from the Nepal Demographic and Health Surveys (NDHS)2016 and 2022. A secondary analysis was conducted using data from the NDHS 2016 ( n = 3,445) and 2022 ( n = 3,839). The outcome variable was lifetime IPV (physical, sexual, or emotional). The study utilized complex samples logistic regression, applying domestic violence-specific sampling weights (d005). A hierarchical modeling strategy was used to develop three models to assess associations. To formally test whether the strength of the association between controlling behavior and lifetime IPV changed over time, performed a pooled analysis including an interaction term (Survey Year × Husband’s Controlling Behavior). Sensitivity analysis was also conducted by redefining the outcome to exclude emotional IPV. The lifetime prevalence of IPV was 25.5% (95% CI: 24.1–26.9) in 2016 and 27.1% (95% CI: 25.7–28.5) in 2022. Husband’s controlling behavior was the strongest independent correlate of lifetime IPV across both waves. In 2016, women whose husbands exhibited controlling behaviors was associated with 4.30 times higher odds of lifetime IPV (AOR: 4.30; 95% CI: 3.40–5.43; p < 0.001). In 2022, this association remained potent, with the odds of lifetime IPV increasing to 5.87 (AOR: 5.87; 95% CI: 4.85–7.11; p < 0.001).A pooled interaction analysis confirmed that this association strengthened significantly over time ( p < 0.05).Sensitivity analysis confirmed that husband’s controlling behavior remained a potent correlate of physical and sexual violence even when emotional IPV was excluded (AOR: 5.10 in 2022; p < 0.001).Other significant correlates included partner’s alcohol consumption (AOR: 2.67 in 2016; 2.23 in 2022), p < 0.001, partner’s unemployment (AOR: 3.06 in 2022) p < 0.001, and a lack of formal education among respondents (AOR: 4.15 in 2022) p < 0.001 respectively. Geographically, women in the Madhesh Province and the Tarai region faced disproportionately higher risks. Furthermore, ethnic disparities persisted, with Muslim women (AOR: 3.15 in 2022) p < 0.001 and those from “Other Tarai Castes” (AOR: 2.41 in 2022) p < 0.001experiencing the highest odds of lifetime violence compared to Brahmin/Chettri women. In conclusion, evidence from 2016 to 2022 underscores that lifetime IPV in Nepal is an entrenched issue strongly associated with patterns of coercive control. The statistically significant intensification of this relationship highlights an urgent need for interventions that move beyond general socio-economic empowerment to target the behavioral correlates and social norms that normalize male dominance. Addressing coercive control is vital to achieving the 2030 Sustainable Development Goals for gender equality in Nepal.