1
|
Bahati C, Nyiranteziryayo A, Izabayo J, Atete P, Sezibera V, Mutesa L. Mental health outcomes of offspring exposed to parental intimate partner violence in Rwanda. BMC Pediatr 2024; 24:419. [PMID: 38956491 PMCID: PMC11218358 DOI: 10.1186/s12887-024-04884-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 06/12/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Children who witness parental intimate partner violence (IPV) are more likely to develop mental health issues compared to those who do not witness such violence. OBJECTIVE The main objective of this study is to assess the association between parental intimate partner violence and child mental health outcomes. METHODOLOGY This cross-sectional study involved 548 participants divided into two groups: parents (N = 304) and offspring (N = 244). The participants were recruited from Mageragere Sector in the City of Kigali (urban), as well as Mbazi and Ruhashya sectors in Huye District (rural). To assess the difference about mental difficulties reported by the offspring, a Mann-Whitney U test was employed to compare the responses of parents and their children on mental health outcomes. Additionally, multiple linear regression analysis was conducted to explore the association between parental intimate partner violence (IPV) and the mental health outcomes of their offspring. RESULTS The results highlighted significant levels of mental and emotional challenges in children, as reported by both parents and the children themselves. Depression and youth conduct problems were more prevalent among the children compared to their parents, whereas anxiety and irritability were more commonly reported by parents than by their children. Intimate partner violence showed to be a predictor of irritability and anxiety symptoms in offspring. In terms of irritability, depression, and youth conduct problems they were identified as predictors of anxiety symptoms. Particularly, anxiety and irritability were revealed to predict youth conduct problems. CONCLUSION The study indicates that parental intimate partner violence (IPV) has an impact on the mental well-being of their offspring. Furthermore, it was observed that there is not only a correlation between IPV and poor mental health outcomes, but also a connection between different mental conditions, implying that children exposed to IPV are more prone to experiencing a range of mental issues. As a result, intervention programs should place emphasis on addressing the mental disorders of both parents and children.
Collapse
Affiliation(s)
- Claire Bahati
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
| | - Amina Nyiranteziryayo
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Josias Izabayo
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Pauline Atete
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Vincent Sezibera
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Leon Mutesa
- Centre for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| |
Collapse
|
2
|
Nuwabaine L, Kawuki J, Amwiine E, Asiimwe JB, Sserwanja Q, Gatasi G, Donkor E, Atwijukiire H. Sexual violence and associated factors among women of reproductive age in Rwanda: a 2020 nationwide cross-sectional survey. Arch Public Health 2023; 81:112. [PMID: 37331931 PMCID: PMC10278278 DOI: 10.1186/s13690-023-01109-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Sexual violence against women is a global public health issue with both short- and long-term effects on the physical and mental health of women. This study aimed to determine the prevalence of sexual violence and its associated factors among women of reproductive age in Rwanda. METHODS We used secondary data from the 2020 Rwanda Demographic and Health Survey of 1,700 participants, who were selected using multistage stratified sampling. Multivariable logistic regression was conducted to explore factors associated with sexual violence using SPSS (version 25). RESULTS Of the 1,700 women of reproductive age, 12.4% (95%CI: 11.0-14.1) had experienced sexual violence. Justified beating (AOR = 1.34, 95%CI: 1.16-1.65), not having health insurance (AOR = 1.46, 95%CI: 1.26-2.40), not being involved in healthcare decision-making (AOR = 1.64, 95%CI: 1.99-2.70), having a husband/partner with primary (AOR = 1.70, 95%CI: 5.47-6.21) or no education (AOR = 1.84, 95%CI: 1.21-3.37), as well as having a husband/partner who sometimes (AOR = 3.37, 95%CI: 1.56-7.30) or often (AOR = 12.87, 95%CI: 5.64-29.38) gets drunk were positively associated with sexual violence. However, women from male-headed households (AOR = 0.52, 95%CI: 0.29-0.92) were less likely to experience sexual violence. CONCLUSIONS There is a need to demystify negative culturally-rooted beliefs favouring sexual violence, such as justified beating, as well as increase efforts to promote women's empowerment and healthcare access. Moreover, engaging men in anti-sexual violence strategies is paramount to addressing male-related issues that expose women to sexual violence.
Collapse
Affiliation(s)
- Lilian Nuwabaine
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda
| | - Joseph Kawuki
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Earnest Amwiine
- Faculty of Medicine, Mbarara University of Science & Technology, Mbarara, Uganda
| | | | | | - Ghislaine Gatasi
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, 210009 Nanjing, Jiangsu Province China
| | - Elorm Donkor
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | | |
Collapse
|
3
|
Li L, Shen X, Zeng G, Huang H, Chen Z, Yang J, Wang X, Jiang M, Yang S, Zhang Q, Li H. Sexual violence against women remains problematic and highly prevalent around the world. BMC Womens Health 2023; 23:196. [PMID: 37101173 PMCID: PMC10134525 DOI: 10.1186/s12905-023-02338-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/08/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Sexual violence is far more prevalent in most societies than is usually suspected in daily life. However, no study has systematically summarized the global prevalence rate and the major outcomes of sexual violence against women. METHODS We directed a wide-raging search in the PubMed, Embase, and Web of Science, catalogs since the beginning to December 2022 for relevant reports about the incidence of sexual fighting touching females. The occurrence frequency was assessed with a random-effects model. The heterogeneity was estimated with I 2 values. Differences by research features were assessed over subgroup evaluation and meta-regression. RESULTS A total of 32 cross-sectional studies were included (a total of 19,125 participants). The pooled sexual violence rate was 0.29 (95% CI = 0.25-0.34). Subgroup analyses found that there was a higher rate of sexual violence against women in 2010-2019 period (0.33, 95% CI = 0.27-0.37), developing countries (0.32, 95% CI = 0.28-0.37), and interview (0.39, 95% CI = 0.29-0.49). The analysis found that more than half of women (0.56, 95% CI = 0.37-0.75) had post-traumatic stress disorder (PTSD) after experiencing sexual violence, and only a third of women considered seeking support (0.34, 95% CI = 0.13-0.55). CONCLUSIONS Nearly one out of every three (29%) women around the world has been a victim of sexual violence in their life. This current study investigated the status and characteristics of sexual violence against women, which could provide an important reference for police and emergency health services management.
Collapse
Affiliation(s)
- Liqing Li
- School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China.
| | - Xin Shen
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guohua Zeng
- School of Economics and Management, Jiangxi University of Science and Technology, Ganzhou, Jiangxi, China
| | - Hongwei Huang
- Department of Health Management Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhensheng Chen
- School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Jiayi Yang
- School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Xiaofang Wang
- School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Ming Jiang
- School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Sule Yang
- School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Qi Zhang
- School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Honglang Li
- School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China.
| |
Collapse
|
4
|
Utaile MM, Ahmed AA, Yalew AW. Multilevel analysis of factors for intimate partner violence during pregnancy in Gammo Goffa Zone, South Ethiopia: A community based study. Front Public Health 2023; 11:1122041. [PMID: 36998288 PMCID: PMC10043311 DOI: 10.3389/fpubh.2023.1122041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 03/15/2023] Open
Abstract
BackgroundIntimate partner violence during pregnancy is a public health problem that can affect both maternal and fetal life. However, its prevalence and associated factors have not been well studied and understood in Ethiopia. Hence, this study was conducted to assess the individual and community-level factors associated with intimate partner violence during pregnancy in Gammo Goffa Zone, South Ethiopia.MethodsA community-based cross-sectional study was conducted among 1,535 randomly selected pregnant women from July to October 2020. Data were collected using an interviewer-administered, standardized WHO multi-country study questionnaire and analyzed using STATA 14. A two level mixed-effects logistic regression model was used to identify factors associated with intimate partner violence during pregnancy.ResultsThe prevalence of intimate partner violence during pregnancy was found to be 48% (95% CI: 45–50%). Factors affecting violence during pregnancy were identified at the community and individual levels. Access to health facilities (AOR = 0.61; 95% CI: 0.43, 0.85), women feeling isolated from the community (AOR= 1.96; 95% CI: 1.04, 3.69), and strict gender role differences (AOR= 1.45; 95% CI: 1.03, 2.04) were among higher-level factors found to be significantly associated with intimate partner violence during pregnancy. Low decision-making power was found to increase the odds of experiencing IPV during pregnancy (AOR= 2.51; 95% CI: 1.28, 4.92). Similarly, maternal education, maternal occupation, living with the partner's family, current pregnancy intended by the partner, dowry payment, and presence of marital conflict were among the individual- level factors found to increase the odds of experiencing intimate partner violence during pregnancy.ConclusionsThe prevalence of intimate partner violence during pregnancy was high in the study area. Both individual and community-level factors had significant implications on maternal health programs related to violence against women. Socio-demographic and socio-ecological characteristics were identified as associated factors. Since it is a multifaceted problem, special emphasis has to be given to multi-sectoral approaches involving all responsible bodies to mitigate the situation.
Collapse
Affiliation(s)
- Mesfin Mamo Utaile
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- *Correspondence: Mesfin Mamo Utaile
| | - Ahmed Ali Ahmed
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Worku Yalew
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
5
|
Maharlouei N, Roozmeh S, Zahed Roozegar MH, Shahraki HR, Bazrafshan K, Moradi-alamdarloo S, Vardanjani HM, Lankarani KB. Intimate partner violence during pregnancy in COVID-19 pandemic: a cross-sectional study from South-west of Iran. BMC Public Health 2023; 23:325. [PMID: 36788571 PMCID: PMC9926421 DOI: 10.1186/s12889-023-15258-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against pregnant women can cause several complications for the mother and her baby, which are life-threatening. Thus, we aimed to find the prevalence of IPV and its associated factors in pregnant women in Shiraz, Iran. METHODS This cross-sectional study was conducted among pregnant mothers in Shiraz between July 2020 and January 2021. The questionnaire consisted of four parts: demographic data, socio-economic status (SES), obstetric and medical history, and questions about IPV. Univariate analysis was performed using Chi-square, McNemar, or Fisher's exact test, and variables with p-value < 0.20 were included in Logistic regression. The odds ratio and CI 95% for variables with p-value < 0.05 were considered statistically significant. RESULTS The overall prevalence of IPV was 93.1% among 830 pregnant women in Shiraz. Psychological violence was the most prevalent type (92.9%), followed by sexual (11%) and physical (7.7%) violence. High SES (OR = 3.21, (CI:1.61-6.41)) was the only risk factor for overall violence, and the age group, 30-34, was a risk factor for physical violence. Mother-desired pregnancy (OR = 26 (Cl:0.09-0.79)) and father-desired pregnancy (OR = 0.91, (CI:0.22-3.80)) were protective factors against physical and sexual violence, respectively. Furthermore, Psychological violence and sexual violence increased during COVID-19 Pandemic (P.value < 0.05). CONCLUSION According to the obtained results, the prevalence of IPV during pregnancy in Shiraz was very concerning, especially psychological violence. Improving conflict-solving skills among family members and addressing economic problems could be considered by health policymakers when designing interventional programs and policies to reduce IPV during pregnancy.
Collapse
Affiliation(s)
- Najmeh Maharlouei
- grid.412571.40000 0000 8819 4698Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shohreh Roozmeh
- grid.412571.40000 0000 8819 4698Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad-hassan Zahed Roozegar
- grid.412571.40000 0000 8819 4698Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Raeisi Shahraki
- grid.440801.90000 0004 0384 8883Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Rahmatieh Educational Complex, Shahrekord, Iran
| | - Khadijeh Bazrafshan
- grid.412571.40000 0000 8819 4698Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shaghayegh Moradi-alamdarloo
- grid.412571.40000 0000 8819 4698Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Molavi Vardanjani
- grid.412571.40000 0000 8819 4698Department of MPH, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran B. Lankarani
- grid.412571.40000 0000 8819 4698Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
6
|
Abegaz MY, Muche HA, Aynalem GL, Anteneh TA, Tibebu NS, Gedef GM, Mengstie AS. Prevalence of sexual violence and associated factors among women attending antenatal care in Debre Markos at public health institutions in north-west Ethiopia, 2021. Front Glob Womens Health 2023; 4:1009272. [PMID: 36891168 PMCID: PMC9986625 DOI: 10.3389/fgwh.2023.1009272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/11/2023] [Indexed: 02/22/2023] Open
Abstract
Background Sexual violence refers to being forced to perform any unwanted sexual act. Due to the negative effects on both the mother and the fetus, sexual assault during pregnancy is a public health concern. Knowing the prevalence of sexual violence during pregnancy helps policymakers understand the extent of the problem and can be considered the first step toward implementing interventions for prevention and treatment. This study was done to determine the prevalence of sexual violence and its associated factors during pregnancy in public hospitals in Debre Markos. Methods An institution-based cross-sectional study was conducted among 306 pregnant women in Debre Markos, north west Ethiopia from May 1 to June 30, 2021, 2021. A systematic random sampling procedure was used to select study participants. Data were collected using a structured and interviewer-administered questionnaire, and a pre-test was done. Both bi-variable and multivariable logistic regression analyses were undertaken to identify significantly associated variables with sexual violence. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a p-value of ≤ 0.05 was used to claim statistical association. Results There were 304 interviewed respondents with a response rate of 99.3%. In this study, the overall prevalence of sexual violence among pregnant mothers during the current pregnancy was 19.4%. A husband who had no formal education {AOR = 3.48; 95% CI: 1.06, 11.39}, pregnant mothers who had no formal education {AOR = 6.1; 95% CI: 1.50-18.11}, pregnant mothers who had secondary education {AOR = 2.80, 95% CI: 1.15, 6.81}, being a housewife {AOR = 3.87, 95 CI:1.21, 12.37}, and being a governmental employee {AOR = 4.49, 95% CI: 1.22, 16.40} were factors associated with sexual violence at the value of p ≤ 0.05. Conclusions and recommendations In this study, approximately one-fifth of the study participants experienced sexual violence during their current pregnancy. To reduce this, interventions should focus on the education of women as well as their partner about violence against women and on initiatives to economically empower women.
Collapse
Affiliation(s)
- Marta Yimam Abegaz
- School of Midwifery Department of Clinical Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Haymanot Alem Muche
- School of Midwifery Department of Clinical Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Getie Lake Aynalem
- School of Midwifery Department of Clinical Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tazeb Alemu Anteneh
- School of Midwifery Department of Clinical Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Nebyu Solomon Tibebu
- School of Midwifery Department of Clinical Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Getachew Muluye Gedef
- School of Midwifery Department of Clinical Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Aregash Sitot Mengstie
- School of Midwifery Department of Clinical Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
7
|
Su Y, D’Arcy C. Interpersonal Violence Around Pregnancy Experienced by Rural and Urban Canadian Women: Correlates and Selected Health Outcomes. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP19042-NP19065. [PMID: 34493096 PMCID: PMC9554279 DOI: 10.1177/08862605211043576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Interpersonal violence around pregnancy is of increasing global public health concern affecting both women themselves and their children. The primary aim of this study is to explore and identify potential correlates of such violence and to examine maternal and birth outcomes subsequent to that violence in a nationally representative sample of urban and rural women in Canada. The data are from the Maternity Experiences Survey (MES), a Canadian population-based postcensus survey administered to 6,421 Canadian mothers in 2006. Survey participants were 15 years and older and had given birth to a singleton and continued to live with their infant at the time of the survey. The survey response rate was 78%. Multivariable logistic regression analyses were used in the analysis with adjustments made for confounding variables. The study findings indicated that living in an urban environment was associated with an increased risk of interpersonal violence experience around the time of pregnancy (OR = 1.31, 95% CI: 1.03-1.66). In addition, being aboriginal, young, unmarried, economically disadvantaged, a nonimmigrant, and having more than four pregnancies, as well as cigarette smoking, alcohol drinking and drug use before the pregnancy were correlated with interpersonal violence around pregnancy. Maternal interpersonal violence experiences were also associated with postnatal depression and stressful life events among both urban and rural mothers. However, maternal interpersonal violence experiences were only associated with preterm birth among rural mothers but not among urban mothers. The present study highlights the need to implement effective interventions for women experiencing interpersonal violence around pregnancy due to its potential impact on maternal and newborn's physical and mental health. Screening and intervention should be targeted high-risk women particularly those who are indigenous, young, unmarried, nonimmigrants, of lower socioeconomic status, and manifesting high risk health behaviors.
Collapse
Affiliation(s)
- Yingying Su
- University of Saskatchewan, Saskatoon,
SK, Canada
| | - Carl D’Arcy
- University of Saskatchewan, Saskatoon,
SK, Canada
| |
Collapse
|
8
|
Aboagye RG, Seidu AA, Asare BYA, Adu C, Ahinkorah BO. Intimate partner violence and timely antenatal care visits in sub-Saharan Africa. Arch Public Health 2022; 80:124. [PMID: 35443697 PMCID: PMC9022289 DOI: 10.1186/s13690-022-00853-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) during pregnancy has negative physical and psychological health consequences on the pregnant women. As such, women who experience IPV during pregnancy are likely to have challenges accessing maternal healthcare services. In this study, we examined the influence of exposure to IPV on timely antenatal care (ANC) visits in sub-Saharan Africa. METHODS Cross-sectional data from the most recent Demographic and Health Survey of twenty-two countries in sub-Saharan Africa between 2012 and 2020 were analysed. Data were obtained from 61,282 women with birth history in the five years prior to the survey. A multilevel logistic regression was used to determine the association between IPV and timely ANC visits while controlling for significant covariates. Adjusted odds ratios (aOR) with 95% Confidence Intervals (CI) were used to present results from the multilevel logistic regression analysis. RESULTS The prevalence of timely ANC visit and IPV were 38.1% and 34.9% respectively. The highest and lowest prevalence of IPV were found in Sierra Leone (52.9%) and Comoros (8.1%), respectively. Timely ANC attendance among pregnant women was more prevalent in Liberia (74.9%) and lowest in DR Congo (19.0%). Women who experienced IPV during pregnancy were less likely to utilize timely ANC (aOR = 0.89, 95% CI = 0.86-0.92) compared to those who did not experience IPV. In terms of the covariates, the odds of timely ANC were higher among women aged 40-44 compared to those aged 15-19 (aOR = 1.35, 95% CI = 1.21-1.51). Higher odds of timely ANC was found among women who were cohabiting (aOR = 1.15, 95% CI = 1.10-1.20), those from the richest wealth quintile (aOR = 1.38, 95% CI = 1.28-1.48), those exposed to watching television (aOR = 1.24, 95% CI = 1.18-1.30), and those with health insurance (aOR = 1.46, 95% CI = 1.37-1.56). CONCLUSION Findings from the study indicate the role of IPV in timely ANC visit in sub-Saharan Africa. To enhance timely ANC visits, there is the need for policy makers to strengthen and enforce the implementation of policies that alleviate IPV during pregnancy. Education and sensitization of married and cohabiting women and men on the negative effects of IPV on timely ANC should be done using media sources such as television. Inequalities in timely ANC can be eliminated through the provision and strengthening of existing maternal health policies such as health insurance.
Collapse
Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.,Faculty of Built and Natural Environment, Department of Real Estate Management, Takoradi Technical University, Takoradi, Ghana
| | - Bernard Yeboah-Asiamah Asare
- Curtin School of Population Health, Curtin University, Perth, Australia.,Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| |
Collapse
|
9
|
Kpienbaareh D, Kofinti RE, Konkor I, Amoak D, Kansanga MM, Luginaah I. Knowledge of pregnancy complications and utilization of antenatal care services in Rwanda. Int J Health Plann Manage 2022; 37:1680-1693. [PMID: 35150019 DOI: 10.1002/hpm.3434] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/30/2021] [Accepted: 01/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND While Rwanda's progress towards achieving the maternal health care targets of the Sustainable Development Goals is impressive, evidence of women's limited utilization of antenatal care (ANC) services in the context of an improved health care system provides an opportunity for exploring other essential but less highlighted factors that may shape ANC service utilization. In this study, we examined the association between women's knowledge of pregnancy complications and the utilization of maternal health services. METHODS We employed logistic regression analysis using the 2015 Rwanda Demographic and Health Survey data. Our analytical sample consisted of women (n = 5883) in their reproductive ages (15-49 years). Three maternal health care indicators, namely, timing of first ANC visit, number of ANC visits, and place of delivery, were explored. We controlled for the effects of socioeconomic and demographic characteristics, including marital status, place of residence and age. RESULTS The results show that women with no knowledge of pregnancy complications were less likely to utilize ANC services within the first trimester (odds ratio [OR] = 0.76, p < 0.01), achieve the WHO recommended minimum of eight visits (OR = 0.66, p < 0.01), and deliver at a health facility (OR = 0.77, p < 0.10). CONCLUSION Given these findings, we recommend restructuring existing maternal health care programs to include rigorous maternal health education.
Collapse
Affiliation(s)
- Daniel Kpienbaareh
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | | | - Irenius Konkor
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, Mississauga, Ontario, Canada
| | - Daniel Amoak
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | | | - Isaac Luginaah
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
10
|
Shen X, Dong H, Jiang H, Cao H, Dowling R, Feng J, Lei Z, Zhao Y, Nui Z, Pu B, Lu Z, Gan Y. The global prevalence of sexual violence against pregnant women: a systematic review and meta-analysis. Women Health 2021; 62:37-45. [PMID: 34886757 DOI: 10.1080/03630242.2021.2011824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
When committed against pregnant women, sexual violence may have adverse health consequences for both the mother and the unborn child. To date, no studies have systematically summarized the global prevalence of sexual violence against pregnant women. We conducted a comprehensive search of PubMed, Embase and Web of Science from inception dates to January 2021 for studies reporting the prevalence of sexual violence against pregnant women. Prevalence was estimated using a random-effects meta-analysis. Heterogeneity was evaluated using the I2 statistic. Differences by study level characteristics were estimated through subgroup analysis and meta-regression. A total of 10 cross-sectional studies (a total of 8,439 participants) were included. The pooled proportion of sexual violence was 0.31 (95% CI: 0.22-0.40). Subgroup analyses showed higher prevalence of sexual violence against pregnant women in the 2010-2019 period (0.35, 95% CI0.15-7.53) and developing countries (0.32, 95% CI0.19-0.45). Almost one in three (31%) pregnant women around the world has been a victim of sexual violence in their lifetime. Sexual violence against pregnant women continues to be a major public health challenge. The global prevalence of sexual violence against pregnant women warrants the collective attention of the entire society.
Collapse
Affiliation(s)
- Xin Shen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hao Dong
- Department Of General Practice, Shouyilu Street Community Health Service Center, Wuhan, Hubei, China
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Hui Cao
- Department of Labor Economics and Management, Beijing Vocational College of Labour and Social Security, Beijing, China
| | - Rowan Dowling
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jing Feng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zihui Lei
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuxin Zhao
- Community Health Service Management Center, Shenzhen Fuyong People's Hospital, Shenzhen, Guangdong, China
| | - Zhenyu Nui
- Department of Public Health and Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang, China
| | - Bo Pu
- School of Business and Tourism, Sichuan Agricultural University, Chengdu, Sichuan, China
| | - Z Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
11
|
Bahati C, Izabayo J, Niyonsenga J, Sezibera V, Mutesa L. Intimate partner violence as a predictor of antenatal care services utilization in Rwanda. BMC Pregnancy Childbirth 2021; 21:754. [PMID: 34749691 PMCID: PMC8574031 DOI: 10.1186/s12884-021-04230-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/22/2021] [Indexed: 11/24/2022] Open
Abstract
Background Although compelling evidence shows that exposure to intimate partner violence (IPV) during pregnancy is detrimental to both physical and mental health of the victims and their fetuses, studies on negative impact of IPV on antenatal care (ANC) services utilization are scarce. Methods The aim of the current study was to determine the impact of IPV exposure on ANC services utilization indicators such as (i) initiation of care within the first 3 months of pregnancy, (ii) receipt of at least four ANC visits and (iii) receipt of care from skilled providers among reproductive age women in Rwanda. This study used the data from the 2014–15 Rwanda Demographic and Health Survey. Multiple logistic regression was used to estimate the effects of physical and sexual IPV on the ANC services utilization indicators. Results Among married women living with their partners with at least one child aged 5 years or under (N = 5116), 17% of them reported physical violence, 22.8% reported psychological violence and 9.2% reported sexual violence. We found that there was a significant negative relationship between physical IPV and both early ANC and sufficient ANC. Women who had experienced physical violence by their partners during the preceding 12 months were less likely to receive more than four ANC visits, (O.R = 0.61, CI = 0.417–0.908) and they were less likely to attend the first ANC visits within the first 3 months (O.R = 0.656, CI = 0.445–0.967). Conclusion In this study, the prevalence of IPV still remains high and there is evidence that it does have significant impact on ANC. Therefore, the results provide support for continued efforts to reduce intimate partner violence, through the improvement of screening for IPV during ANC visits.
Collapse
Affiliation(s)
- Claire Bahati
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
| | - Josias Izabayo
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Japhet Niyonsenga
- Mental Health & Behaviour Research Group, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Vincent Sezibera
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Léon Mutesa
- Centre of Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| |
Collapse
|
12
|
Kabir R, Chakraborty R, Vinnakota D, Siddika N. Intimate partner violence constrains timely utilisation of antenatal care services among Armenian women: Results from a nationally representative sample. Int J Crit Illn Inj Sci 2021; 11:209-214. [PMID: 35070910 PMCID: PMC8725806 DOI: 10.4103/ijciis.ijciis_199_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 12/27/2020] [Accepted: 04/16/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Well-timed utilisation of antenatal care (ANC) services during pregnancy emphatically impact pregnancy outcomes. Intimate Partner Violence (IPV) predominance during pregnancy is exceptionally noticeable in Armenia, yet we have restricted information on the association between IPV and ANC attendance. The aim of this study was to determine the association between IPV and utilisation of adequate ANC services among Armenian women. Methods: A nationally representative sample survey from 2015 to 2016 Armenia Demographic and Health Survey was considered for this study. A total of 6116 women were interviewed. To estimate the association between outcome and explanatory variable, Pearson's Chi-square test followed by bivariate logistic regression analysis were performed. Results: About 58% of participants, more than 35 years old has encountered IPV. Women with advanced education (54.7%) attended ANC services between 0 and 3 months. It was found that only the richer women are two times more likely to visit ANC services above four times than other groups and its association with IPV claimed that richer women are more likely to face IPV. Moreover, women who are residing with alcoholic husbands/partners are two times more likely to suffer from partner abuse (P < 0.001). Conclusion: The impact of IPV on accessibility and timely utilisation of ANC services in Armenia cannot be overlooked as IPV is causing risk in healthy delivery and the country's overall productivity in a broader perception.
Collapse
Affiliation(s)
- Russell Kabir
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, UK
| | | | - Divya Vinnakota
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, UK
| | - Nazeeba Siddika
- Centre for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| |
Collapse
|
13
|
Jatta JW, Baru A, Fawole OI, Ojengbede OA. Intimate partner violence among pregnant women attending antenatal care services in the rural Gambia. PLoS One 2021; 16:e0255723. [PMID: 34352019 PMCID: PMC8341542 DOI: 10.1371/journal.pone.0255723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 07/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) refers to any behavior by either a current or ex-intimate partner or would-be rejected lover that causes physical, sexual, or psychological harm. It is the most common form of violence in women's lives. According to a World Health Organization report, about 1 in 3 women worldwide experience at least one form of IPV from an intimate partner at some point in her life. In the Gambia, about 62% of pregnant women experience at least one form of violence from an intimate partner. IPV has severe physical and mental health consequences on a woman ranging from minor bodily injury to death. It also increases the risk of low birth weight, premature delivery, and neonatal death. METHODS A health facility-based cross-sectional study design was carried out to assess the magnitude and factors associated with intimate partner violence among pregnant women seeking antenatal care in the rural Gambia. The study enrolled 373 pregnant women, and a multi-stage sampling technique was used to select the respondents. An interviewer-administered structured questionnaire was used to obtain information from the study participants. The collected data were analyzed using SPSS Ver.22. Bivariate and multivariate logistic regression were used to determine the association between dependent and independent variables. Odds ratio with 95% confidence interval (CI) was computed to determine the presence and strength of associated factors with IPV. RESULT The study reveals that the prevalence of IPV in The Gambia is 67%, with psychological violence (43%) being the most common form of IPV reported by the respondents. The multivariate logistic regression result reveals that being aged 35 years or older [AOR 5.1(95% CI 1.5-17.8)], the experience of parents quarreling during childhood [AOR 1.7(95% CI 1.0-2.75)], and having cigarette smoking partners [AOR 2.3 (95% CI 1.10-4.6)] were significantly associated with IPV during pregnancy. CONCLUSION This study has demonstrated that all forms of IPV in rural Gambia are frequent. Women older than 35 years, had experienced parents quarreling, had a partner who smoked, and a partner who fight with others were more likely report IPV compared to other pregnant women in the study. We recommend that IPV screening should be included as an integral part of routine antenatal care services in The Gambia. Community-based interventions that include indigenous leaders, religious leaders, and other key stakeholders are crucial to create awareness on all forms of IPV and address the risk factors found to influence the occurrence of IPV in rural Gambia.
Collapse
Affiliation(s)
- Joseph W. Jatta
- Institute of Life and Earth Science (Including Health and Agriculture), Pan African University, Ibadan, Nigeria
- Slum and Rural Health Initiative Network, Research and Collaboration Department, SRHIN/Africa, Ibadan, Nigeria
| | - Ararso Baru
- Institute of Life and Earth Science (Including Health and Agriculture), Pan African University, Ibadan, Nigeria
- Slum and Rural Health Initiative Network, Research and Collaboration Department, SRHIN/Africa, Ibadan, Nigeria
- College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia
| | - Olufunmilayo I. Fawole
- Institute of Life and Earth Science (Including Health and Agriculture), Pan African University, Ibadan, Nigeria
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladosu A. Ojengbede
- Institute of Life and Earth Science (Including Health and Agriculture), Pan African University, Ibadan, Nigeria
- Centre for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
14
|
Boyacioğlu NE, Günaydın S, Özcan NK, Dinç Kaya H. Intimate partner violence during pregnancy in turkey: A systematic review and meta-analysis. Perspect Psychiatr Care 2021; 57:1515-1527. [PMID: 34076899 DOI: 10.1111/ppc.12879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/16/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The objective of the present research was to identify the prevalence of and risk factors for intimate partner violence during pregnancy (IPVP) in Turkey by conducting a systematic review and meta-analysis. DESIGN AND METHODS In the current research, 22 primary studies published between January 2005 and January 2019 were investigated. FINDINGS Low educational and income levels of both the woman and her partner, unintended marriage and pregnancy, living in a crowded family, a high number of children and a history of violence, unemployment of the partner, and the consumption of alcohol are the most significant risk factors of IPVP. PRACTICE IMPLICATIONS This study shows that violence against women, which is a serious problem in Turkey as well as all over the world, also continues in a critical period, such as the pregnancy period.
Collapse
Affiliation(s)
- Nur Elçin Boyacioğlu
- Department of Gerontology, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sevil Günaydın
- Department of Midwifery, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Neslihan Keser Özcan
- Department of Midwifery, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hüsniye Dinç Kaya
- Department of Midwifery, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
15
|
Sari IP, Setyowati S, Ungsianik T. Partners' behavior as the main cause of domestic violence experienced by pregnant adolescents in Jakarta. J Public Health Res 2021; 10. [PMID: 34060745 PMCID: PMC9309627 DOI: 10.4081/jphr.2021.2341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Adolescent pregnancy leads to a variety of complex problems. Adolescents with
an unwanted pregnancy potentially face a stigma or rejection by parents and
friends as well as facing threats to be a victim of domestic violence.
Violence experienced by pregnant adolescents has a negative impact on the
health status of the mother and their fetus. This study aimed to identify
the factors triggering domestic violence on pregnant adolescents in
Jakarta. Design and Methods The design of the study was cross-sectional study with convenience sampling
(n=230). The tools used for data collection were questionnaires. Results The results of the bivariate analysis showed that the factors associated with
domestic violence suffered by pregnant adolescents were the partner's
violence history (p=0.000), partner's behaviors (p=0.000), economic status
(p=0.002) and family's support (p=0.03). The partner's behavior was the most
influential factor that contributed 73.96 times the potential occurrences of
domestic violence against pregnant adolescents (p=0.000; OR=73.96). Conclusions The involvement of the partner during the pregnancy process is necessary for
understanding and comprehension of the changes, which may possibly occur due
to the partner's pregnancy.
Collapse
Affiliation(s)
| | - S Setyowati
- Department of Maternity Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| | - Titin Ungsianik
- Department of Maternity Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| |
Collapse
|
16
|
Investigating the relationship between women's experience of intimate partner violence and utilization of maternal healthcare services in India. Sci Rep 2021; 11:11172. [PMID: 34045492 PMCID: PMC8160003 DOI: 10.1038/s41598-021-89688-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 04/30/2021] [Indexed: 12/30/2022] Open
Abstract
The utilization of maternal healthcare services is a key measure to reduce the incidence of maternal mortality. This study aims to examine the relationship between women’s exposure to intimate partner violence (IPV) and the utilization of maternal healthcare services, using a large-scale nationally representative data among Indian women. Data for this study were drawn from the fourth round of the National Family Health Survey (NFHS-4), which is collected during 2015–2016. In order to analyze, we utilized 24,882 currently married women aged 15–49 years who had at least one living child in the past five years preceding the survey. Women’s experience of IPV, which is manifested in various forms of physical, emotional, and/or sexual violence perpetrated by the partner, was considered as the key explanatory variable. Adequate antenatal care (ANC) [four or more ANC visits], delivery assistance by the skilled health provider, and postnatal care (PNC) within two days of delivery were used as outcome variables for assessing the utilization of maternal healthcare services. Descriptive statistics, cross-tabulation, Pearson’s chi-square test, and bivariate and multivariate logistic regression models were used in this study. Approximately 26% of the sample women (currently married) experienced any form of IPV in the past year. Bivariate analyses show that the utilization of all three components of maternal healthcare services was lower among women who experienced physical, sexual, or emotional violence, as compared to those who did not face any violence perpetrated by the partner. Multivariate analysis indicates that women’s exposure to IPV was significantly associated with a lower likelihood of adequate ANC utilization (Adjusted Odds Ratio [OR]: 0.90, 95% CI 0.84–0.97), even after controlling for socio-demographic characteristics. However, IPV had no significant relationship with skilled delivery assistance and unexpectedly a positive association with PNC usage (Adjusted OR: 1.09, 95% CI 1.02–1.16) in the adjusted analysis. Our study suggests formulating strategies toward the prevention of husband-perpetrated violence against women and targeting women who experienced spousal violence to improve their utilization of maternal healthcare services.
Collapse
|
17
|
Idriss-Wheeler D, Yaya S. Exploring antenatal care utilization and intimate partner violence in Benin - are lives at stake? BMC Public Health 2021; 21:830. [PMID: 33931050 PMCID: PMC8085473 DOI: 10.1186/s12889-021-10884-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 04/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background The republic of Benin ranks in the bottom third of countries recently assessed for ANC coverage and its Ministry of Family and National Solidarity (2009) reported close to 70% of Beninese women suffered abuse at least once in their lifetime. Utilization of antenatal care (ANC) services is key to positive health outcomes for both mother and infant. This study examined the impact of intimate partner violence (IPV) on the utilization of ANC services in Benin using both the basic 4 visit model (ANC-4) and the updated WHO recommended 8-visit model (ANC-8). Methods Data used for this study were collected from the nationally representative 2017–2018 Benin Demographic Health Survey (BDHS) on ever-partnered women aged 15–49 who had completed both reproductive maternal health and domestic violence modules of the survey. Descriptive statistics and multivariate logistic regression analysis were performed to determine significant factors associated with ANC utilization in Benin. Results Over 40% of the women (n = 3084) reported experience of IPV in their lifetime. Findings revealed that women who ever experienced IPV (OR 0.753, 95% CI: 0.628–0.901; p = 0.002) had 25% less odds of accessing the basic four ANC visits. IPV was not found to be a factor in accessing at least eight ANC visits. With increasing number of children, there was less likelihood of accessing at least four and at least eight visits. Being in the richest quintile (OR 5.490, 95% CI 3.907–7.714; p < 0.000 for ANC-4; OR, 5.781, 95% CI: 3.208–10.41; p < 0.000), making decisions on household and health care (OR 1.279, 95% CI: 1.042–1.569 for ANC-4; OR, 1.724; 95% CI: 1.170–2.540; p = 0.006 for ANC-8), and getting paid cash for work increased the chances of utilizing ANC-four (OR 1.451, 95% CI: 1.122–1.876; 0.005) but not for ANC-eight. Belonging to the Muslim faith decreased the odds of ANC utilization compared to all other religions. Conclusion This work revealed key areas for maternal health policy makers and service providers in Benin to appropriately plan effective policies (i.e., alleviate poverty; equitable health services access; cultural sensitivity) and necessary interventions (i.e. ANC education, IPV prevention, paid employment, alcohol cessation) to increase utilization of ANC. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10884-9.
Collapse
Affiliation(s)
- Dina Idriss-Wheeler
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
| |
Collapse
|
18
|
Teshome A, Gudu W, Bekele D, Asfaw M, Enyew R, Compton SD. Intimate partner violence among prenatal care attendees amidst the COVID-19 crisis: The incidence in Ethiopia. Int J Gynaecol Obstet 2021; 153:45-50. [PMID: 33368273 PMCID: PMC9087760 DOI: 10.1002/ijgo.13566] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 11/10/2022]
Abstract
Objective To assess the incidence and predictors of intimate partner violence (IPV) during pregnancy amidst the coronavirus disease 2019 pandemic. Methods This cross‐sectional study was conducted at the prenatal care clinic of St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia, among pregnant women from 31 August to 2 November 2020. Participants were interviewed using Open Data Kit. Logistic regression was used to assess predictors. Results Among the 464 pregnant women, 33 (7.1%) reported IPV during pregnancy, and among these 24 (72.7%) reported emotional violence, 16 (48.5%) reported sexual violence, and 10 (30.3%) reported physical violence. Among the study participants, only 8 (1.7%) were screened for IPV. IPV was reported 3.27 times more often by women who reported that their partner chewed Khat compared with those women whose partner did not (adjusted odds ratio [aOR] 3.27; 95% confidence interval [CI] 1.45–7.38), and 1.52 times more often women who reported that their partner drank alcohol compared with those women whose partner did not (aOR 1.52; 95% CI 1.01–2.28). Conclusion Very few women were screened for IPV. Partners drinking alcohol and chewing Khat are significantly positively associated with IPV during pregnancy. IPV screening should be included in the national management protocol of obstetric cases of Ethiopia. Very few women were screened for intimate partner violence during pregnancy, a finding that has implications for policy moving forward.
Collapse
Affiliation(s)
- Abel Teshome
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Wondimu Gudu
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Delayehu Bekele
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mariamawit Asfaw
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ruhama Enyew
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Sarah D Compton
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
| |
Collapse
|
19
|
Chilanga E, Collin-Vezina D, Khan MN, Riley L. Prevalence and determinants of intimate partner violence against mothers of children under-five years in Central Malawi. BMC Public Health 2020; 20:1848. [PMID: 33267864 PMCID: PMC7709392 DOI: 10.1186/s12889-020-09910-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against women is a global human rights violation and a public health problem. The phenomenon is linked to adverse health effects for women and children. Mothers of young children in Malawi can be particularly at risk because of gender-based power imbalances. The objectives of this study were to examine the prevalence and the risk factors of IPV against mothers of children under-five years of age in rural Malawi. METHODS A multistage, cross-sectional study design was used. A sample of 538 mothers of young children was randomly selected from postnatal clinics in Dowa district. The WHO's Violence against women screening instrument was used to collect data. Logistic regressions were used to determine risk factors that were associated with IPV against mothers. RESULTS Overall prevalence of all four forms of IPV against mothers of under-five children was 60.2%. The prevalence of IPV controlling behavior, psychological, physical, and sexual violence were 74.7, 49.4, 43.7 and 73.2% respectively. In multivariate analyses, mothers whose partners had extra marital affairs were more likely to experience controlling behavior (AOR: 4.97, 95% CI: 2.59-8.55, P = 0.001), psychological (AOR: 2.14, 95% CI: 1.486-3.472, P = 0.001) and physical (AOR: 2.29, 95% CI: 1.48-3.94, P = 0.001) violence than mothers whose partners did not have extra marital affairs. Mothers whose partners consume alcohol were more likely to experience sexual violence (AOR: 2.00, 95% CI: 1.17-3.41, P = 0.001) than mothers whose partners did not drink. Finally, mothers who spent more than 30 min drawing water were at greater risk of experiencing IPV than mothers who spent less than 30 min. CONCLUSION This study found a significantly higher prevalence of IPV against mothers of under-five children in rural Malawi compared to women in the general population. Micro and macro-level programs aimed at mitigating the partners' potential risk behaviors identified in this study are suggested. Public health programs that support increased household access to safe water are also recommended to help undermine IPV against mothers.
Collapse
Affiliation(s)
- Emmanuel Chilanga
- Department of Geography, University of Livingstonia, Livingstonia, Malawi.
- Centre for Research on Children and Families, School of Social Work, McGill University, Montreal, Canada.
| | - Delphine Collin-Vezina
- Centre for Research on Children and Families, School of Social Work, McGill University, Montreal, Canada
| | | | - Liam Riley
- Balsillie School of International Affairs, Wilfrid Laurier University, Waterloo, Canada
| |
Collapse
|
20
|
Musa A, Chojenta C, Loxton D. High rate of partner violence during pregnancy in eastern Ethiopia: Findings from a facility-based study. PLoS One 2020; 15:e0233907. [PMID: 32497059 PMCID: PMC7272015 DOI: 10.1371/journal.pone.0233907] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/14/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Intimate partner violence during pregnancy can contribute to maternal mortality and morbidity by limiting women's ability to receive maternal health services including antenatal care and skilled delivery care. In Ethiopia, evidence regarding intimate partner violence during pregnancy is limited, and no previous studies have been conducted in the Harari region. Therefore, this study aimed to investigate the prevalence and associated factors of intimate partner violence during pregnancy among women who had given birth in public hospitals in Harari regional state, eastern Ethiopia. METHODS A hospital-based cross-sectional study was conducted from November 2018 to April 2019 among women who had given birth in public hospitals in Harari regional state, East Ethiopia. A systematic random sampling method was employed to select 648 participants. Data were collected using an interviewer-administered standardized questionnaire based on the World Health Organization Multi-Country Study on Women's Health and Domestic Violence against Women survey. Crude and adjusted odds ratios with respective confidence intervals were computed. Variables with a p-value of ≤0.05 were considered to have a significant association with intimate partner violence during pregnancy. RESULTS The prevalence of intimate partner violence during the most recent pregnancy was found to be 39.81%. Furthermore, the prevalence of physical, emotional and sexual violence were found to be 25.93%, 25.62% and 3.7%, respectively. Longer duration of marriage (adjusted odds ratio = 1.68, 95% confidence interval = 1.01-2.79), most recent pregnancy being unplanned (adjusted odds ratio = 1.55, 95% confidence interval = 1.03-2.34), experiencing controlling behaviour by a partner, (adjusted odds ratio = 2.23, 95% confidence interval = 1.46-3.40) and having an attitude that justifies intimate partner violence (adjusted odds ratio = 1.60, 95% confidence interval = 1.09-2.36) were associated with experiencing intimate partner violence. CONCLUSION The prevalence of intimate partner violence during pregnancy was found to be high. Pregnancy monitoring programs, which can detect and intervene with regard to partner's controlling behaviors and women's perception regarding justification of intimate partner violence, especially in those women with an unplanned pregnancy, could help to reduce intimate partner violence during pregnancy. Further, changing social norms that condone violence through advocacy and awareness creation might help in preventing partner violence.
Collapse
Affiliation(s)
- Abdulbasit Musa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| |
Collapse
|
21
|
Ashenafi W, Mengistie B, Egata G, Berhane Y. Prevalence and Associated Factors of Intimate Partner Violence During Pregnancy in Eastern Ethiopia. Int J Womens Health 2020; 12:339-358. [PMID: 32440229 PMCID: PMC7221416 DOI: 10.2147/ijwh.s246499] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 03/27/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Intimate partner violence is a major public health problem and a gross violation of human rights. The consequences of this violation are severe during pregnancy as the fetus/newborn could also be affected negatively. The aim of this study was to assess the prevalence and associated factors of intimate partner violence during pregnancy (IPVP) in Eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among 3015 postpartum mothers in Eastern Ethiopia. Data were collected using the WHO Violence Against Women questionnaire. Factors associated with IPVP were assessed by a log-binomial regression model using Stata version 14. RESULTS The overall prevalence of IPVP was 30.5% (95% CI: 28.8, 32.1); the prevalence for psychological violence was 24.4% (95% CI: 22.9, 26.0), physical violence was 11.9% (95% CI: 10.8, 13.2) and sexual violence was 11.0% (95% CI: 9.9, 12.2). About 95% of acts of sexual violence were in the form of forced sex. In multivariable analysis, women's education was associated with a decreased prevalence of all forms of IPVP. Previous experience of infant loss and not drinking alcohol were associated with lower prevalence of all IPVP types, except for the physical form. Working for cash and having medium household decision-making autonomy increased the prevalence of all forms of IPVP. Being older, living in an extended family, husband's/partner's habitual khat chewing and discordant pregnancy intentions increased the prevalence ratio (PR) of all forms of IPVP, except for sexual violence. Compared to being urban, being rural decreased the PR of sexual IPVP by 59% (adjusted prevalence ratio [APR]=0.41; 95% CI: 0.27, 0.60) and psychological IPVP by 32% (APR=0.68; 95% CI: 0.53, 0.87). Husband's/partner's support for antenatal care use decreased the PR of physical IPVP by 56% (APR=0.44; 95% CI: 0.25, 0.78). CONCLUSION Nearly one-third of pregnant women experienced IPVP. The great majority of them were subjected to forced sex by their husband/partner. This calls for urgent attention at all levels of societal organization, requiring stakeholders and policy makers to tackle the situation.
Collapse
Affiliation(s)
- Wondimye Ashenafi
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bezatu Mengistie
- Department of Environmental Health Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gudina Egata
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yemane Berhane
- Department of Epidemiology, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| |
Collapse
|
22
|
Magnitude of Intimate Partner Violence and Associated Factors among Pregnant Women in Ethiopia. ADVANCES IN PUBLIC HEALTH 2020. [DOI: 10.1155/2020/1682847] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background. Intimate partner violence during pregnancy is the most common and major public health problem and human rights issue worldwide and has a negative effect on the lives of both mother and fetus. Despite its prominence, this issue has received little attention in Ethiopia as well as many sub-Saharan African countries. This study assessed the magnitude of intimate partner violence and associated factors among pregnant women in Ofla District, Tigray, Ethiopia. Methods. A facility-based cross-sectional study was conducted from March 1 to 30, 2019, among 543 pregnant women who visited antenatal care in the health facilities. A systematic random sampling technique was used to select study participants. Pretested, interviewer-administered data collection was done using a standardized World Health Organization multicountry questionnaire for women’s health and domestic violence against women. Bivariable and multivariable logistic regression analyses were carried out to identify factors associated with violence. p value was set at p<0.05. Results. The overall prevalence of intimate partner violence during the current pregnancy was 37.5%: psychological (25.1%), sexual (17.7%), and physical violence (13.4%). Violence was associated with unplanned pregnancy ((AOR = 4.56, 95% CI: (2, 10.28)), unmarried women ((AOR = 2.59, 95% CI: (1.18, 5.73)), having alcoholic partner ((AOR = 3.3, 95% CI: (2.1, 5.16)), spouse’s multiple sexual partners status ((AOR = 5.1, 95% CI: (2.2, 12)), acceptance of violence by women ((AOR = 1.85, 95% CI: (1.1, 3.16)), low decision-making power of women ((AOR = 2.64, 95% CI: (1.6, 4.3)), and no interest in current pregnancy by partner ((AOR = 5.9, 95% CI: (2.36, 14.9)). Conclusions. More than one-third of pregnant women experienced intimate partner violence during a recent pregnancy. This is high and may lead to health consequences for both mothers and fetuses. Addressing gender inequitable norms, the culture of silence (support) to intimate partner violence in the community and women’s reproductive health information through intervention measures are very important to minimize the problem.
Collapse
|
23
|
Akamike IC, Uneke CJ, Uro-Chukwu HC, Okedo-Alex IN, Chukwu OE. Predictors and facilitators of gender-based violence in sub-Saharan Africa: a rapid review. JOURNAL OF GLOBAL HEALTH REPORTS 2019. [DOI: 10.29392/joghr.3.e2019076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
24
|
Gómez-Fernández MA, Goberna-Tricas J, Payá-Sánchez M. El saber experiencial de las matronas de Atención Primaria en la detección de violencia de género durante el embarazo. Estudio cualitativo. ENFERMERIA CLINICA 2019; 29:344-351. [DOI: 10.1016/j.enfcli.2019.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 05/11/2019] [Accepted: 05/19/2019] [Indexed: 11/25/2022]
|
25
|
Jaraba SMR, Garcés-Palacio IC. Association between violence during pregnancy and preterm birth and low birth weight in Colombia: Analysis of the demographic and health survey. Health Care Women Int 2019; 40:1149-1169. [PMID: 30874485 DOI: 10.1080/07399332.2019.1566331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To explore the association between low birth weight and preterm birth with violence during pregnancy, we conducted a cross-sectional study by using the 2010 Colombian Demographic and Health Survey. We conducted bivariate analyses, binomial logistic regression, and stratified models by age, and 14,520 women were included. There was no association between violence and low birth weight. Nonetheless, an association with preterm birth in women aged over 35 was observed (OR 1.98, 95%CI 1.23, 3.17). Prenatal care appeared to be a protective factor for both outcomes. This research unexpectedly showed that supplementation with folic acid and iron was associated with preterm birth.
Collapse
Affiliation(s)
- Sara Milena Ramos Jaraba
- Grupo de Epidemiologia, Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Isabel C Garcés-Palacio
- Grupo de Epidemiologia, Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, Medellín, Colombia
| |
Collapse
|
26
|
Shoqirat N, Almajali A, Alsaraireh A. "From a Family Home to Hell": Experiences and Consequences of Intimate Partner Violence Among Married Jordanian Women. Issues Ment Health Nurs 2019; 40:33-40. [PMID: 30118373 DOI: 10.1080/01612840.2018.1485794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study aimed to understand the experience of intimate partner violence (IPV) and related consequences among married Jordanian women. A qualitative exploratory design using semi-structured interviews (n = 10) was employed. Analysis of the qualitative data revealed two main themes. The first theme focused on the transition: "From a family home to Hell". The second theme was described as the path from wellness to illness, including an analysis of the various consequences of IPV. A continuous educational program for the victims themselves and healthcare professionals along with a serious partnership with legal and political institutions in Jordan is urgently needed.
Collapse
Affiliation(s)
| | | | - Arwa Alsaraireh
- c Maternity and Child Health, Nursing Faculty , Mutah University , Karak , Jordan
| |
Collapse
|
27
|
Njim T, Mbolingong FN. Intimate partner violence and depression among pregnant women in the North west region of Cameroon: a research proposal. BMC Res Notes 2018; 11:868. [PMID: 30522499 PMCID: PMC6282249 DOI: 10.1186/s13104-018-3979-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/04/2018] [Indexed: 01/22/2023] Open
Abstract
Objectives Intimate partner violence (IPV) in pregnancy is a major public health concern due to its harmful effects on both the mother and the unborn foetus. In this study, we aim to assess the prevalence and correlates of both IPV and depression in pregnant women in the northwest region of Cameroon. Specifically: (1) To determine the prevalence of IPV in a group of pregnant women in the northwest region of Cameroon. (2) To determine the prevalence of depression amongst these women. (3) To assess the various sociodemographic determinants of IPV in these women. (4) To determine if IPV is associated with depression and to assess other sociodemographic and clinical correlates of depression. Results This cross-sectional study will include a minimum of 369 pregnant women recruited by convenience sampling from primary and secondary healthcare facilities in the northwest region of the country. Data be collected via a printed questionnaire administered by a trained healthcare professional. IPV will be assessed using the World Health Organisation Violence Against Women Instrument and depression will be assessed using the Patient Health Questionnaire-9. Multivariable logistic regression will be used to identify independent predictors of IPV and depression.
Collapse
Affiliation(s)
- Tsi Njim
- Health and Human Development (2HD) Research Network, Douala, Cameroon.
| | | |
Collapse
|
28
|
Rurangirwa AA, Mogren I, Ntaganira J, Govender K, Krantz G. Quality of antenatal care services in Rwanda: assessing practices of health care providers. BMC Health Serv Res 2018; 18:865. [PMID: 30453996 PMCID: PMC6245627 DOI: 10.1186/s12913-018-3694-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 11/08/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although most pregnant women in Rwanda visit antenatal care (ANC) clinics, little has been studied about the quality of services being provided. We investigated the ANC providers' (HCPs) current practices in relation to prevention, management and referral of maternal conditions as well as the information provided to pregnant women attending ANC services in Rwanda. METHODS This facility-based, cross-sectional study included 312 ANC providers as participants and a review of 605 ANC medical records from 121 health centers. Data collection was performed using an interviewer-administered questionnaire and a structured observation checklist. For the analyses, descriptive statistics and bi-and multivariable logistic regression were used. RESULTS Nurses and midwives in ANC services failed to report a number of pregnancy-related conditions that would need urgent referral to a higher level of health care. Midwives did somewhat better than nurses in reporting these conditions. There was no statistically significant difference in how nurses and midwives informed pregnant women about pregnancy-related issues. Ever been trained in how to manage a pregnant woman exposed to violence was reported by 14% of the participants. In 12, 13 and 15% of the medical records there was no report on tetanus immunization, anthelmintic treatment and syphilis testing, respectively. CONCLUSION The providers in ANC clinics reported suboptimal practices on conditions of pregnancy that needed urgent referral for adequate management. Information to pregnant women on danger signs of pregnancy, recommended medicines and tests do not seem to be consistently provided. Midwifery training in Rwanda should be expanded so that most of staff at ANC clinics are trained as midwives to help lower maternal and child mortality and morbidity.
Collapse
Affiliation(s)
- Akashi Andrew Rurangirwa
- Department of Epidemiology and Biostatistics, School of Public Health, University of Rwanda, Kigali, Rwanda
- Section of Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Box 453, 405 30 Göteborg, Sweden
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Joseph Ntaganira
- Department of Epidemiology and Biostatistics, School of Public Health, University of Rwanda, Kigali, Rwanda
| | - Kaymarlin Govender
- Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, KwaZulu-Natal, 4000 South Africa
| | - Gunilla Krantz
- Section of Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
29
|
Gichane MW, Moracco KE, Thirumurthy H, Okitolonda EW, Behets F, Yotebieng M. Intimate partner violence and prevention of mother to child transmission of HIV: Evidence from Kinshasa, Democratic Republic of Congo. PLoS One 2018; 13:e0203471. [PMID: 30161260 PMCID: PMC6117078 DOI: 10.1371/journal.pone.0203471] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 08/21/2018] [Indexed: 11/19/2022] Open
Abstract
Intimate partner violence (IPV) is a risk factor for non-adherence to HIV treatment for women, however the evidence on the impact of IPV on uptake of the prevention of mother to child transmission of HIV (PMTCT) cascade is inconclusive. We examined data from 433 HIV positive pregnant women in Kinshasa, Democratic Republic of Congo, enrolled between April 2013 and August 2014 and followed-up through 6 weeks postpartum. Participants were asked about their IPV experiences in a face-to-face interview at enrollment. Measures of PMTCT cascade included: uptake of clinical appointments and services, viral suppression, and adherence to antiretrovirals (ARV). Approximately half of the sample (51%) had experienced some form of IPV; 35% had experienced emotional abuse, 29% physical abuse, and 19% sexual abuse. There were no statistically significant associations between experiencing any form of IPV and uptake of clinical appointments and services (Adjusted Prevalence Ratio [aPR] = 1.02; 95% [CI]: 0.89–1.17), viral load suppression (aPR = 1.07, 95% CI:0.96–1.19) and ARV adherence (aPR = 1.01, 95% CI: 0.87–1.18). Findings from this study indicate that, among HIV-infected pregnant women enrolled in PMTCT care, experiencing IPV does not reduce adherence to clinic visits and services, adherence to ARV. The high prevalence of IPV in this population suggests that IPV screening and intervention should be included as part of standard care for PMTCT.
Collapse
Affiliation(s)
- Margaret W. Gichane
- The University of North Carolina at Chapel Hill, Department of Health Behavior, Chapel Hill, NC, United States of America
- * E-mail:
| | - Kathryn E. Moracco
- The University of North Carolina at Chapel Hill, Department of Health Behavior, Chapel Hill, NC, United States of America
| | - Harsha Thirumurthy
- University of Pennsylvania Pearlman School of Medicine, Department of Medical Ethics and Health Policy, Philadelphia, PA, United States of America
| | - Emile W. Okitolonda
- The University of Kinshasa, School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Frieda Behets
- The University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, NC, United States of America
- The University of North Carolina at Chapel Hill, Department of Social Medicine, Chapel Hill, NC, United States of America
| | - Marcel Yotebieng
- The University of North Carolina at Chapel Hill, Department of Social Medicine, Chapel Hill, NC, United States of America
- The Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH, United States of America
| |
Collapse
|
30
|
Rurangirwa AA, Mogren I, Ntaganira J, Govender K, Krantz G. Intimate partner violence during pregnancy in relation to non-psychotic mental health disorders in Rwanda: a cross-sectional population-based study. BMJ Open 2018; 8:e021807. [PMID: 29997142 PMCID: PMC6082444 DOI: 10.1136/bmjopen-2018-021807] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of non-psychotic mental health disorders (MHDs) and the association between exposure to all forms of intimate partner violence (IPV) during pregnancy and MHDs. DESIGN Cross-sectional population-based study conducted in the Northern Province of Rwanda and Kigali city. PARTICIPANTS AND SETTINGS Totally, 921 women who gave birth ≤13 months before being interviewed were included. Simple random sampling was done to select villages, households and participants. Community health workers helped to identify eligible participants and clinical psychologists, nurses or midwives conducted face-to-face interviews. The collected data were analysed using descriptive statistics and bivariable and multivariable logistic regression modelling RESULTS: The prevalence rates of generalised anxiety disorder, suicide ideation and post-traumatic stress disorder (PTSD) were 19.7%, 10.8% and 8.0%, respectively. Exposure to the four forms of IPV during pregnancy was highly associated with the likelihood of meeting diagnostic criteria for each of the non-psychotic MHDs investigated. Physical, psychological and sexual violence, showed the strongest association with PTSD, with adjusted ORs (aORs) of 4.5, 6.2 and 6.3, respectively. Controlling behaviour had the strongest association with major depressive episode in earlier periods with an aOR of 9.2. CONCLUSION IPV and MHDs should be integrated into guidelines for perinatal care. Moreover, community-based services aimed at increasing awareness and early identification of violence and MHDs should be instituted in all villages and health centres in Rwanda. Finally, healthcare providers need to be educated and trained in a consistent manner to manage the most challenging cases quickly, discreetly and efficiently.
Collapse
Affiliation(s)
- Akashi Andrew Rurangirwa
- Department of Epidemiology and Biostatistics, School of Public Health, University of Rwanda, Kigali, Rwanda
- Section of Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden
| | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Joseph Ntaganira
- Department of Epidemiology and Biostatistics, School of Public Health, University of Rwanda, Kigali, Rwanda
| | - Kaymarlin Govender
- Health Economics and HIV/AIDS Research Division (HEARD), Universityof KwaZulu-Natal, Durban, South Africa
| | - Gunilla Krantz
- Section of Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden
| |
Collapse
|
31
|
Gashaw BT, Schei B, Magnus JH. Social ecological factors and intimate partner violence in pregnancy. PLoS One 2018; 13:e0194681. [PMID: 29596497 PMCID: PMC5875784 DOI: 10.1371/journal.pone.0194681] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 03/07/2018] [Indexed: 11/18/2022] Open
Abstract
Background Intimate partner violence (IPV) during pregnancy increases adverse pregnancy outcomes. Knowledge of societal, community, family and individual related factors associated with IPV in pregnancy is limited in Ethiopia. Our study examined these factors in an Ethiopian context. Materials and methods A cross sectional study was conducted among pregnant women attending antenatal care at governmental health institutions, using a consecutive probability sampling strategy. A total of 720 pregnant women were interviewed by five trained nurses or midwives, using a standardized and /pretested survey questionnaire. Bivariate and multivariate logistic regression analyses were applied to assess factors contributing to IPV. We used Akaike’s information criteria, to identify the model that best describes the factors influencing IPV in pregnancy. Results Among the women interviewed, physical IPV was reported by 35.6%, and lifetime emotional or physical abuse by 81.0%. Perceiving violence as a means to settle interpersonal conflicts, presence of supportive attitudes of wife beating in the society, regarding violence as an expression of masculinity, and presence of strict gender role differences in the society, were all positively associated to IPV in pregnancy. The presence of groups legitimizing men’s violence in the community, feeling isolated, having no social support for victims, and presence of high unemployment, were the perceived community related factors positively associated with IPV in pregnancy. Conclusion IPV in pregnancy is very prevalent in Ethiopia and is associated with multiple social ecologic factors. Reduction of IPV in pregnancy calls for cross sectorial efforts from stakeholders at different levels.
Collapse
Affiliation(s)
- Bosena Tebeje Gashaw
- College of Health Sciences, Jimma University, Jimma, Ethiopia
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Berit Schei
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynaecology, St. Olav's hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jeanette H Magnus
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| |
Collapse
|