Controlling behavior, power relations within intimate relationships and intimate partner physical and sexual violence against women in Nigeria

Prevalence of intimate partner violence among Indian women and their determinants: a cross-sectional study from national family health survey - 5

INTRODUCTION

Intimate partner violence (IPV) can be described as a violation of human rights that results from gender inequality. It has arisen as a contemporary issue in societies from both developing and industrialized countries and an impediment to long-term development. This study evaluates the prevalence of IPV and its variants among the empowerment status of women and identify the associated sociodemographic parameters, linked to IPV.

METHODS

This study is based on data from the National Family Health Survey (NFHS) of India, 2019-21 a nationwide survey that provides scientific data on health and family welfare. Prevalence of IPV were estimated among variouss social and demographic strata. Pearson chi-square test was used to estimate the strength of association between each possible covariate and IPV. Significantly associated covariates (from univariate logistic regression) were further analyzed through separate bivariate logistic models for each of the components of IPV, viz-a-viz sexual, emotional, physical and severe violence of the partners.

RESULTS

The prevalence of IPV among empowered women was found to be 26.21%. Among those who had experienced IPV, two-thirds (60%) were faced the physical violence. When compared to highly empowered women, less empowered women were 74% more likely to face emotional abuse. Alcohol consumption by a partner was established to be attributing immensely for any kind of violence, including sexual violence [AOR: 3.28 (2.83-3.81)].

CONCLUSIONS

Our research found that less empowered women experience all forms of IPV compared to more empowered women. More efforts should to taken by government and other stakeholders to promote women empowerment by improving education, autonomy and decision-making ability.

Magnus J, Assefa N, Wordofa MA. The protocol for a cluster randomized controlled trial to evaluate couple-based violence prevention education and its ability to reduce intimate partner violence during pregnancy in Southwest Ethiopia

BACKGROUND

A significant proportion of women in Ethiopia suffer from violence by their intimate partner during pregnancy, which has adverse maternal and newborn outcomes. Couple-focused interventions are effective in reducing and/or controlling violence between women and their intimate partners. However, interventions addressing intimate partners of the victims are not well studied, particularly in the Ethiopian setting. This study aims to assess the effect of couple-based violence prevention education on intimate partner violence during pregnancy.

METHODS

We will use a cluster randomized controlled trial to evaluate the effectiveness of couple-based violence prevention education compared to routine care in reducing intimate partner violence during pregnancy. Sixteen kebeles will be randomly assigned to 8 interventions and 8 control groups. In the trial, 432 couples whose wife is pregnant will participate. Health extension workers (HEWs) will provide health education. Data will be collected at baseline and endline. All the collected data will be analyzed using Stata version 16.0 or SPSS version 25.0. We will use the McNemar test to assess the differences in outcomes of interest in both intervention and control groups before and after the intervention for categorical data. A paired t-test will be used to compare continuous outcome of interest in the intervention and the control groups after and before the intervention. The GEE (Generalized Estimating Equation), will be used to test the independent effect of the intervention on the outcome of the interest. Data analysis will be performed with an intention-to-treat analysis approach. During the analysis, the effect size, confidence interval, and p-value will be calculated. All tests will be two-sided, and statistical significance will be declared at p < 0.05.

DISCUSSION

We expect that the study will generate findings that can illuminate violence prevention strategies and practices in Ethiopia.

TRIAL REGISTRATION

It has been registered on ClinicalTrials.gov as NCT05856214 on May 4, 2023.

Examining Risk Factors of Intimate Partner Violence Victimization in Central America: A Snapshot of Guatemala and Honduras

The current study examines country-specific risk factors of intimate partner violence (IPV) victimization among Guatemalan and Honduran women. More specifically, we examine if (in)equality between partners, experience of controlling or emotionally abusive behavior, and components of the intergenerational transmission of violence significantly affect the risk of lifetime IPV victimization for Guatemalan (N = 5,645) and Honduran women (N = 9,427). We address this by analyzing both the 2014 to 2015 Guatemala Demographic and Health Survey and the 2011 to 2012 Honduras Demographic and Health Survey. Results suggest that equality between partners operates differently across the two nations, which is likely related to social norms in each country. In particular, having more decisional input is a protective factor against IPV victimization for Guatemalan women. Increased educational attainment, however, is a risk factor for IPV victimization among Honduran women. Implications, especially as they pertain to social service agencies and programming, are discussed.

Depression and Intimate Partner Violence (IPV) in mothers 6 weeks to 12 months post-delivery in a rural setting in Kenya

Using a cohort of 544 postpartum mothers, 6 weeks to 12 months post-delivery in the largely rural Makueni County in Kenya, we aimed to determine: (1) the prevalence of postpartum depression (PPD) and the prevalence of each of the four domains of intimate partner violence (IPV), that is physical violence, sexual violence, emotional violence, and controlling behavior; (2) the co-occurrence of PPD and IPV; (3) risk factors and associations between sociodemographic variables and IPV, PPD and IPV and PPD co-occurring. We concurrently administered a researcher-designed sociodemographic ad hoc questionnaire, the WHO Intimate Partner Violence questionnaire and the Mini-International Neuropsychiatric Interview for adults (MINI Plus) for DSM-IV/ICD10 depression. The prevalence of PPD was 14.5%; Emotional violence 80.3%; Controlling behavior 74.4% (a form of emotional violence); Physical violence 40.3%; Sexual violence 28.9%. We found the following overlaps: 39% of participants reported both physical and emotional violence; 39% had both sexual and emotional violence; 15% experienced physical and sexual violence; and 15% of participants reported physical, sexual, and emotional violence. Postpartum depression was associated with physical violence during pregnancy, self-employed status, history of mood disorders and medical problems in the child. Further, we report associations between various types of IPV and history of depression, physical violence during pregnancy, low education level, marital status, and current depression diagnosis. IPV and PPD were highly prevalent in our population of postpartum mothers. Various types of IPV were significantly associated with various sociodemographic indicators while only sexual violence was significantly associated with PPD. Based on our results, we provide suggestions for potential interventions in the Kenyan setting.

Associations between sexual violence and women's sexual self-consciousness

Background

Sexual violence is a global public health problem that has serious and multiple consequences for the victims' health.

Objective

This study was conducted to determine associations between sexual violence and women's sexual self-consciousness.

Methods

In the analytical cross-sectional study, 340 eligible married women of reproductive age who have been referred to comprehensive health centers of Rasht, participated. Simple random sampling followed by cluster sampling was used to reach eligible study participants. The data collection tool was a three-part questionnaire including a demographic information form, sexual violence questionnaire, and sexual self-consciousness scale.

Results

More than 66% of the participants in this study were exposed to sexual violence by their current spouses/partners. The highest prevalence of sexual violence was in the dimension of unwillingness to have sex (49%), and the lowest in the verbal dimension was 2.1%. Participants were 4.11 ± 5.18. There was a significant positive correlation between the total score of sexual violence and the total score of sexual self-consciousness of participants (P <0.001, r = 469).

Conclusion

According to the findings, there is a significant positive correlation between SSC and sexual violence, so prevention policies for sexual violence should be focused on skill-based programs and empowering women.

Overlooked impact of less severe physical violence on antenatal care visits: Findings from South Asia

Background

In South Asia, women often experience intimate partner violence (IPV) and have limited access to maternal health services (MHS). However, the effects of IPV on antenatal care (ANC) visits remain unclear. This study aimed to examine the impact of IPV of different forms and severities on ANC visits in South Asia.

Methods

This cross-sectional study used the latest available data from demographic and health surveys conducted in Bangladesh, India, Afghanistan, Nepal, Maldives, and Pakistan. The study sampled 4467 women who had given birth within the past 12 months and were interviewed for IPV. IPV was measured by binary variables indicating the presence of physical violence (PV), categorised into less severe (LSPV) and severe physical violence (SPV), emotional violence (EV), and sexual violence (SV). ANC utilization was measured using binary variables indicating whether respondents had any, at least four, or at least eight ANC visits, as recommended by World Health Organization (WHO). Logistic regressions adjusted for survey weights were used to assess associations between ANC utilization and exposure to IPV during pregnancy and lifetime.

Results

The prevalence of LSPV, SPV, EV, and SV during pregnancy were 14.5%, 4.4%, 11.6%, and 4.1%. LSPV experience during pregnancy was associated with decreased likelihoods of at least four ANC visits (odds ratio (OR) = 0.55; 95% confidence interval (CI) = 0.40-0.76) and eight ANC visits (OR = 0.53; 95% CI = 0.31-0.90). Results of lifetime exposure to IPV followed similar patterns. Lifetime exposure to LSPV was associated with decreased likelihoods of at least four ANC visits (OR = 0.55; 95% CI = 0.41-0.74) and eight ANC visits (OR = 0.47; 95% CI = 0.29-0.77).

Conclusion

This study highlights the negativities of LSPV on the frequency of women seeking ANC visits. Policies are necessary to identify women at risk of the often-overlooked LSPV early and provide protective interventions to promote maternal health in South Asia.

Exploring the association between attitudes towards wife beating and intimate partner violence using a dyadic approach in three sub-Saharan African countries

OBJECTIVE

The present study examines the association between attitudes towards wife beating and intimate partner violence (IPV) using a dyadic approach in three sub-Saharan countries.

SETTING

We use data from the most recent Demographic and Health Survey cross-sectional studies which were conducted between 2015 and 2018 in Malawi, Zambia and Zimbabwe PARTICIPANTS: Our sample comprised 9183 couples who also had completed the information on the domestic violence questions and our variables of interest.

RESULTS

Our results indicate that women in these three countries are generally comparatively more inclined to justify marital violence than their husbands or partners. In terms of IPV experience, we found that when both partners endorsed wife beating, the risk of experiencing IPV was twice as likely after controlling for other couple-level and individual factors (OR=1.91, 95% CI 1.54-2.50, emotional violence; OR=2.42, 95% CI 1.96-3.00, physical violence; OR=1.97, 95% CI 1.47-2.61, sexual violence). The risk of IPV was also higher when the women alone endorsed IPV (OR=1.59, 95% CI 1.35-1.86, emotional violence; OR=1.85, 95% CI 1.59-2.15, physical violence; OR=1.83, 95% CI 1.51-2.22, sexual violence) than when the men alone were tolerant (OR=1.41, 95% CI 1.13-1.75, physical violence; OR=1.43, 95% CI 1.08-1.90, sexual violence).

CONCLUSIONS

Our findings confirm that attitudes towards violence are perhaps one of the key indicators of IPV prevalence. Therefore, to break the cycle of violence in the three countries, more attention must be paid to attitudes towards the acceptability of marital violence. Programmes tailored to gender role transformation and promote non-violent gender attitudes are also needed.

Intimate partner violence among young women in Ibadan, Nigeria: are there slum and non-slum differences?

This study determined the past-year prevalence of physical, sexual and psychological intimate partner violence (IPV) and associated factors among young women in urban slums and non-slums of Ibadan, Nigeria.A cross-sectional study, using a multistage cluster sampling method was used to select 1050 ever-partnered young women aged between 18 and 24 years from the five Local Government Areas (LGAs) in Ibadan municipal. All localities were classified into slums and non-slums using the UN-Habitat 2003 criterion. Independent variables were respondents' and partners' characteristics. Dependent variables were physical, sexual and psychological IPV. Data were analysed using descriptive statistics and binary logistic regression model (α0.05).Prevalence of physical (31.4%, 13.4%), sexual (37.1%, 18.3%), and psychological IPV (58.6%, 31.5%) were significantly higher in the slum than non-slum communities. Multivariate analysis showed that secondary education (aOR:0.45, 95%CI: 0.21 - 0.92) reduced IPV experience while being unmarried (aOR:2.83, 95%CI: 1.28 - 6.26), partner's alcohol use (aOR:1.97, 95%CI: 1.22 - 3.18), and partner's relationship with other women (aOR:1.79, 95%CI: 1.10 -2.91) increased IPV experience in slum communities. In non-slum communities, having children (aOR:2.99, 95%CI: 1.05-8.51), non-consensual sexual debut (aOR: 1.88, 95%CI: 1.07-3.31) and witness of abuse in childhood (aOR:1.82: 95%CI: 1.01 - 3.28) increased experience of IPV. Acceptance of IPV and partner's witness of abuse in childhood increased experience of IPV in both settings.This study confirms that IPV is common among young women in Ibadan, Nigeria, but higher among women in slum communities. Findings also showed different factors associated with IPV in slum and non-slum communities. Therefore, targeted interventions for each urban stratum are recommended.

Determinants of intimate partner controlling behavior targeting women in Türkiye

Background/aim

Intimate partner controlling behavior toward women is an important form of intimate partner violence (IPV), both in terms of limiting women's daily lives and in terms of reproducing patriarchal culture and male dominance in societies at the micro level. A limited number of studies in the literature have identified the male intimate partner's controlling behavior as a dependent variable, which is important for understanding the determinants of this type of IPV. There is also a significant gap in the literature in terms of studies focusing on the case of Türkiye. Thus, the main aim of this study was to determine the socio-demographic, economic and violence-related factors that have an effect on women's status in terms of exposure to control behavior in Türkiye.

Methods

These factors were examined by using binary logistic regression analysis, based on the micro data set collected by the Hacettepe University's Institute of Population Studies in the 2014-dated National Research on Domestic Violence against Women in Türkiye. A total of 7,462 women between the ages of 15 and 59 were interviewed face-to-face.

Results

The findings of the study revealed that women are more likely to be exposed to controlling behavior if they live in rural areas, are unmarried, speak Turkish as their mother tongue, have bad or very bad health conditions, justify men's violence and are afraid of their intimate partners. As women's age, level of education and income contribution increase, their likelihood of exposure to controlling behavior decreases. However, women's exposure to economic, physical and emotional violence also increases their likelihood of exposure to controlling behavior.

Conclusion

The findings highlighted the importance of creating public policies that make women less vulnerable to men's controlling behavior, providing women with methods and mechanisms of resistance and raising public awareness of the exacerbating effects of controlling behavior on social inequalities.

Risk factors for intimate partner emotional violence among women in union in Uganda

Introduction

Despite the growing evidence of the prevalence of gender-based violence in Uganda, less is known about the factors influencing intimate partner emotional violence (IPEV) among married women in the country. This study investigated the social demographic factors associated with IPEV among married women aged 15 years and older.

Data and methods

The study used the 2016 Uganda Demographic Healthy Survey (UDHS) data. A weighted sample of 5,642 women who had been in a union was selected. A binary logistic regression model was fitted to analyze the predictors of IPEV.

Results

Almost four in 10 (38%) married women experienced IPEV. Witnessing parental violence (OR = 1.37, CI = 0.59-0.92), partner's controlling behavior (OR = 4.26, CI = 3.29-5.52), and attaining age 35+ (OR = 1.44, CI = 1.06-1.95) increased the odds of IPEV. Residing in rural areas (OR = 0.004, CI = 0.48-0.99) and having higher education (OR = 0.51, CI = 0.26-1.00) decreased the odds of IPEV.

Conclusion and implications

Witnessing parental violence, alcohol consumption, age, place of residence, partner's controlling behavior, and level of education influence IPEV among married women in Uganda. The findings have several implications including strengthening IPEV-prevention campaigns, women empowerment, and alcohol consumption regulations.

Intimate partner violence linked to gambling: cohort and period effects on the past experiences of older women

BACKGROUND

Problem gambling increases the risk of experiencing intimate partner violence (IPV). People impacted by gambling-related IPV face distinctive challenges, and these may be compounded by intersections with gender, generational influences and contextual factors. This study explored the past experiences of older women affected by male partner violence linked to gambling, and how these were shaped by cohort and period effects and problem gambling. Cohort effects are the generational characteristics of a group born at a particular time, while period effects relate to prevailing external conditions at the time of the abuse, including laws, services and practices.

METHODS

A larger study exploring the nature of the relationship between problem gambling and IPV recruited 72 women through help services and advertising. The current study analysed a subset of interviews with 22 women aged 50 years or over. We analysed the data using adaptive grounded theory to explore the intersection between IPV, gambling, and cohort and period effects.

RESULTS

Cohort effects on the women's experiences of IPV included gendered attitudes, traditional views of marriage, silence surrounding IPV, reticence to disclose the abuse, and little understanding of problem gambling. These influences deterred women from questioning their partner's gambling, and to instead keep the gambling and abuse hidden. Many women did not recognise abuse linked to gambling as IPV, since gambling was considered a normal, harmless pastime. Having a gambling problem exacerbated violence and coercive control by male partners as traditional gender norms supported male authority over their female partner. Women with a gambling problem sometimes felt they deserved the abuse. Period effects included a lack of IPV and gambling services, gendered service responses, failure to prioritise the women's safety, and no consideration by services of the role of gambling in the abuse.

CONCLUSION

Reducing gender inequality is critical to reduce male partner violence towards women. Women impacted by gambling-related IPV, including the legacy of past abuse, need service responses that recognise all forms of abuse, understand the historical and contextual factors that exacerbate it, and recognise how gambling can amplify IPV. A reduction in problem gambling is needed to reduce gambling-related IPV.

Trend analysis of multi-level determinants of maternal and newborn postnatal care utilization in Pakistan from 2006 to 2018: Evidence from Pakistan Demographic and Health Surveys

BACKGROUND

Postnatal care (PNC) is crucial for maternal and newborn health. Healthcare-seeking practices within the postpartum period help healthcare providers in early detection of complications related to childbirth and post-delivery period. This study aims to investigate trends of PNC utilization from 2006 to 2018, and to explore the effects of multi-level determinants of both maternal and newborn PNC in Pakistan.

METHODS

Secondary data analysis of the last three waves of the nationally representative Pakistan Demographic and Health Surveys (PDHSs) was conducted Analysis was limited to all those women who had delivered a child during the last 5 years preceding each wave of PDHS Bivariate and multivariate logistic regression was applied to determine the association of maternal and newborn PNC utilization with multi-level determinants at individual, community, and institutional levels.

RESULTS

In Pakistan, an upward linear trend in maternal PNC utilization was found, with an increase from 43.5 to 63.6% from 2006 to 2018. However, a non-linear trend was observed in newborn PNC utilization, with an upsurge from 20.6 to 50.5% from 2006 to 2013, nonetheless a decrease of 30.7% in 2018. Furthermore, the results highlighted that the likelihood of maternal and newborn PNC utilization was higher amongst older age women, who completed some years of schooling, were employed, had decision-making and emotional autonomy, had caesarean sections, and delivered at health facilities by skilled birth attendants. Multivariate analysis also revealed higher odds for women of older age, who had decision-making and emotional autonomy, and had caesarean section deliveries over the period of 2006-2018 for both maternal and newborn PNC utilization. Further, higher odds for maternal PNC utilization were found with parity and size of newborn, while less for ANC attendance and available means of transportation. Furthermore, increased odds were recorded for newborn PNC utilization with the number of children, ANC attendance, gender of child and mass media exposure from 2006 to 18.

CONCLUSION

A difference in maternal and newborn PNC utilization was found in Pakistan, attributed to multiple individual (socio-demographic and obstetrics), community, and institutional level determinants. Overall, findings suggest the need to promote the benefits of PNC for early diagnosis of postpartum complications and to plan effective public health interventions to enhance women's access to healthcare facilities and skilled birth assistance to save mothers' and newborns' lives.

Effect of physical mobility, decision making and economic empowerment on gender-based violence among married youth in India-SAWERA project

Background

Preventing and responding to gender-based violence (GBV) is both a human rights imperative and a multifaceted economic issue. GBV can also act as a barrier to economic empowerment. The aim of the study was to examine the association between women’s empowerment (physical mobility, decision making and economic resources) and GBV among married youth in India.

Methods

Community based cross-sectional study was conducted among married youth in the age group of 15–24 years, in two selected districts of Uttar Pradesh and Rajasthan, India. The data was collected from 578 youth. Pre-validated scales were used to assess women’s empowerment indicators (physical mobility, decision making and economic resources). The outcomes assessed were scales on physical and sexual violence. Multivariate regression models examined associations between women’s empowerment, spousal characteristics, socio-economic status and demographics.

Results

The overall results of the study found that restricted physical mobility had a negative association with sexual violence [AOR: 0.49; CI 0.26–0.92]. Women with no decision-making power had higher odds of physical violence [AOR: 2.12; CI 0.01–4.43] and sexual violence [AOR: 1.96; CI 1.02–3.77]. Having no economic resources had a negative association with sexual violence [AOR: 0.19; CI 0.09–0.39]. Women going through spousal controlling behavior had a higher likelihood of physical [AOR: 3.79; CI 1.75–8.19] and sexual violence [AOR: 4.03; CI 2.09–7.79]. It was also found that married women from rural areas and other ethnic backgrounds had higher odds of physical violence.

Conclusion

There is a crucial need to work towards women’s empowerment, with progressive gender roles such as greater decision-making, physical mobility and economic resources to reduce GBV. An established method that has worked in various contexts is adopting gender transformative approaches that involve men.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-023-15421-4.

Intimate partner violence among HIV-positive women in discordant relationships attending care and treatment clinics in Dar es Salaam, Tanzania

Background

Intimate partner violence (IPV) toward women is a public health concern affecting many countries across the world. Globally, 30% of women experience lifetime physical, sexual, or psychological harm. HIV-positive women in discordant relationships are at higher risk of experiencing IPV than other women. This study aimed to determine the magnitude and factors associated with intimate partner violence among HIV-positive women in discordant relationships attending HIV care and treatment clinics in Dar es Salaam, Tanzania.

Methods

An analytical cross-sectional study was conducted among 411 HIV-positive women who were in discordant relationships attending HIV care and treatment clinics in eight selected healthcare facilities in Dar es Salaam from June 2021 to July 2021. A questionnaire with structured questions on social-demographic information and factors associated with intimate partner violence was used. Data were collected electronically using the Open Data Kit (ODK) system, cleaned, and stored. Descriptive analysis was done and presented in frequency distribution and cross-tabulation. A chi-square was used to determine the differences in variables, and the modified Poisson regression model was used to estimate adjusted prevalence risk ratios (APRRs) with 95% CI for factors associated with IPV. Variables were considered statistically significant at 95% CI and p < 0.05. All statistical analyses were conducted using STATA version 15.

Results

The mean age of the participants was 36.2 (standard deviation [SD] ±7.8). The majority of women had attained primary education, i.e., 237 (57.7%). Over 65.7% of HIV-positive women in discordant relationships had ever experienced IPV. Women whose partners had primary and secondary education, were alcohol users, and were solely decision-makers in the family were strongly associated with IPV.

Conclusion

Close to two-thirds of HIV-positive women who were in discordant relationships attending HIV care and treatment clinics in selected healthcare facilities in Dar es Salaam had ever experienced at least one form of IPV. Low level of education of the partner, alcohol use, and power relation in decision-making were significantly associated with IPV. We recommend routine screening of IPV for HIV-positive women who are in discordant relationships attending HIV care and treatment clinics. Joint efforts are needed in addressing the factors associated with IPV in discordant couples.

Assessment of Microfinance Interventions and Intimate Partner Violence: A Systematic Review and Meta-analysis

IMPORTANCE

An estimated 27% of ever-partnered women aged 15 to 49 years have experienced intimate partner violence (IPV) in their lifetimes, which has been associated with a wide range of both acute and chronic illness. Poverty is thought to be a major driver of IPV, and economic empowerment programs may reduce violence.

OBJECTIVE

To evaluate whether microfinance interventions are associated with reductions in various forms of IPV.

DATA SOURCES

On August 3, 2022, PubMed, CINAHL, Embase, Web of Science, EconLit, and 5 global health databases were searched from inception.

STUDY SELECTION

Included studies were randomized clinical trials evaluating the effect of microfinance interventions vs control on exposure to IPV. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline.

DATA EXTRACTION AND SYNTHESIS

Authors independently assessed study eligibility, extracted prespecified data, and evaluated risk of bias using the Cochrane Risk of Bias tool.

MAIN OUTCOMES AND MEASURES

Outcome measures of interest were exposure to overall IPV and 4 World Health Organization-designated IPV domains: physical, psychological and emotional, sexual, and controlling behaviors. Univariate meta-analyses using a random effects model were used to calculate the standardized mean differences (SMDs) and 95% CIs for each IPV outcome. The Grading of Recommendations Assessment, Development, and Evaluation method was used to rate the certainty of findings.

RESULTS

Overall, 10 randomized clinical trials met inclusion criteria, with a total of 16 136 participants, of whom 98% identified as women, with a mean age of 28.9 years. Compared with no intervention, participation in microfinance was associated with lower rates of psychological and emotional violence (SMD, 0.87; 95% CI, 0.80-0.95; I2 = 46%; high certainty), sexual violence (SMD, 0.76; 95% CI, 0.63-0.90; I2 = 44%; low certainty), and controlling behaviors (SMD, 0.82; 95% CI, 0.74-0.92; I2 = 54%; high certainty). There was no significant association with physical violence (SMD, 0.89; 95% CI, 0.76-1.04; very-low certainty).

CONCLUSIONS AND RELEVANCE

This systematic review and meta-analysis of microfinance interventions found a reduction in exposure to psychological and emotional IPV as well as controlling behaviors among participants receiving microfinance interventions, with high certainty evidence. Further work is needed to evaluate which types of microfinance interventions are most effective at reducing the various forms of IPV.

Cycles of Violence Among Young Women in Namibia: Exploring the Links Between Childhood Violence and Adult Intimate Partner Violence From the Violence Against Children and Youth Survey

Background: Violence against children is a global public health crisis and is associated with poor mental and physical health outcomes. Childhood violence may also increase the risk of subsequent violence revictimization by an intimate partner. We aimed to understand cycles of violence among adolescent girls and young women in Namibia to inform violence prevention and treatment interventions. Methods: The 2019 Namibia Violence Against Children and Youth Survey (VACS) examined the prevalence of childhood violence and intimate partner violence among 18-24 year old adolescent girls and young women (N = 2434). Using the data, we assessed the prevalence of childhood violence, defined as any physical, sexual, or emotional violence victimization prior to age 18, and estimated the prevalence of intimate partner violence (IPV) after age 18. We used a weighted logistic regression to assess whether childhood violence exposure was associated with subsequent experience of IPV after age 18. Results: Adolescent girls and young women in Namibia had a statistically significant higher odds of experiencing IPV if they had experienced any childhood violence including physical, sexual, and/or emotional violence (adjusted odds ratio [aOR]: 2.93; 95% Confidence Interval [95% CI: 1.64-5.23). IPV was also significantly associated with childhood physical (aOR: 1.81; 95% CI: 1.07-3.05), sexual (aOR: 3.79; 95% CI: 2.54-5.67), or emotional (aOR: 2.39; 95% CI: 1.18-4.86) violence when each were considered separately. We also observed a dose-response relationship between the number of types of childhood violence and IPV experience as a young adult. Conclusions: Childhood violence is a significant predictor of subsequent violence revictimization by an intimate partner. This analysis provides unique insights on cycles of violence among adolescent girls and young women in Namibia and points to the need for interventions during childhood to prevent violence against children and break this cycle among young women in sub-Saharan Africa.

Women’s and male partners’ socio-demographic and economic characteristics associated with contraceptive decision making in Nigeria

Background

Women’s ability to make contraceptive decision can determine their contraceptive use which can improve their reproductive health and career. Improvement in such ability can increase contraceptive prevalence in Nigeria. However, factors that promote contraceptive decision-making among women are scarcely studied. This study examined factors associated with women’s individual or joint contraceptive decision-making in Nigeria.

Methods

Secondary (cross-sectional) data were analysed. The data were extracted from the individual recode file of the 2018 Nigeria Demographic and Health Survey (DHS). Partnered women (i.e., currently married or living with a partner) aged 15–49 years and currently using contraceptives before the survey were considered. They constituted 4,823 in total. Their data were analysed using frequency and percentage distributions of variables, Chi-square tests of independence and multinominal logistic regression.

Results

Findings reveal that 23% (1,125) of women made their own contraceptive decision, nearly 67% (3,213) were joint decision makers, and 10% (491) stated that their male partners had decided for them. The probability of solely making contraceptive decision and being a joint decision maker (relative to being a male partner’s decision) was higher among women above 29 years and aged 30–34 years (than women aged 15–24 years) respectively as well as among the employed (than the unemployed) and among those from Yoruba ethnic group (than their counterparts from Hausa/Fulani/Kanuri/Beri Beri) respectively. The probability of being responsible for contraceptive decision (than being the male partner’s decision) was higher among women from the Igbo group and women whose male partners desired more children (than those with the same number of desired children) respectively. The probability of being the main decision maker (relative to being the male partner) was lower among women in the poorer (RRR = 0.39; 95%CI = 0.21–0.73; p = 0.01), middle (RRR = 0.47; 95%CI = 0.25–0.90; p = 0.02) and richest (RRR = 0.41; 95%CI = 0.20–0.82; p = 0.01) groups respectively, than the poorest women. The probability of being a joint decision maker was higher among women with secondary education (than the uneducated), practised Christianity (than the Muslims/ others), and among those residing in the North West region (than those in North East) respectively. However, the probability of being a joint decision-maker was lower among women whose partners desire more children and those who did not know their partners’ desires.

Conclusions

Women’s age, highest level of education, employment status, wealth index, ethnicity, religion, region of residence and male partners’ desire for children are associated with contraceptive decision making respectively. There is a need for reproductive empowerment interventions in Nigeria that devise effective ways of improving contraceptive decision-making power of partnered women aged 15–24 years, unemployed, in the poorer and richest groups, from the Hausa/Fulani/Kanuri/Beri Beri ethnic group, practising Islam/ other religions, have the same fertility desire as their partners and those who do not know their male partner’s desire for children respectively. Women whose partners desire more children should be empowered to participate effectively in contraceptive decision making.

COVID-19 and family violence: A rapid review of literature published up to 1 year after the pandemic declaration

Background

After the World Health Organization declared COVID-19 a pandemic on March 11, 2020, public health restrictions were introduced to slow COVID-19 transmission and prevent health systems overload globally. Work-from-home requirements, online schooling, and social isolation measures required adaptations that may have exposed parents and children to family violence, including intimate partner violence and child abuse and neglect, especially in the early days of the pandemic. Thus, we sought to: (1) examine the occurrence of family violence; (2) identify factors associated with family violence; and (3) identify relevant recommendations, from COVID-19 literature published up to 1 year after the pandemic declaration.

Methods

This review was registered on PROSPERO (CRD42021241622), employed rapid review methods, and extracted data from eligible papers in medical and health databases published between December 1, 2019 and March 11, 2021 in MEDLINE, PsycINFO, CINAHL, and Embase.

Findings

28 articles including 29 studies were included in the rapid review. While many studies of families/households revealed rises in family violence incidence, official justice, police, and emergency department records noted declines during the pandemic. Parental stress, burnout, mental distress (i.e. depression), difficulty managing COVID-19 measures, social isolation, and financial and occupational losses were related to increases in family violence. Health services should adopt approaches to prevent family violence, treat victims in the context of public health restrictions, and increase training for digital service usage by health and educational professionals.

Interpretation

Globally, restrictions aimed to limit the spread of COVID-19 may have increased the risk factors and incidence of family violence in communities. Official records of family violence may be biased toward under-reporting in the context of pandemics and should be interpreted with caution.

Funding

RESOLVE Alberta, Canada and the Emerging Leaders in the Americas Program (ELAP), Global Affairs Canada.

Domestic Coercive Control and Common Mental Disorders Among Women in Informal Settlements in Mumbai, India: A Cross-Sectional Survey

Coercive control behaviors central to the abuse of power appear more frequent than other types of domestic violence, but little is known about its frequency, features, and consequences for women in India. We aimed to examine the prevalence of domestic coercive control and its association with physical, sexual, and emotional domestic violence in the preceding year and symptoms of depression, anxiety, and suicidal thinking. In a cross-sectional survey, we interviewed 4,906 ever-married women aged 18-49 years living in urban informal settlements in Mumbai, India. We developed a 24-item scale of coercive control, assessed physical, sexual, and emotional violence using existing questions, and screened for symptoms of depression with the Patient Health Questionnaire (PHQ9), anxiety with the Generalized Anxiety Disorder (GAD7) questionnaire, and suicidal thinking with questions developed by the World Health Organization. Estimates involved univariable and multivariable logistic regression models and the prediction of marginal effects. The prevalence of domestic coercive control was 71%. In total, 23% of women reported domestic violence in the past 12 months (emotional 19%, physical 13%, sexual 4%). Adjusted models suggested that women exposed to controlling behavior had greater odds of surviving emotional (aOR 2.1; 95% CI 1.7, 2.7), physical (1.4; 1.0, 1.9), and sexual (1.8; 1.1, 3.0) domestic violence in the past 12 months; and higher odds of a positive screen for moderate or severe depression (1.7; 1.3, 2.2), anxiety (2.1; 1.3, 3.1), and suicidal thinking (1.7; 1.2, 2.3), and increased with each additional indicator of coercive control behavior. When women reported 24 indicators of coercive control, the adjusted predicted proportion with moderate or severe depressive symptoms was 60%, anxiety 42%, and suicidal thinking 17%. Inclusion of coercive control in programs to support domestic violence, would broaden our understanding of domestic abuse to resemble most victims experience and improve interventions.

Gambling-Related Intimate Partner Violence Against Women: A Grounded Theory Model of Individual and Relationship Determinants

This study aimed to examine how problem gambling interacts with gendered drivers of intimate partner violence (IPV) against women to exacerbate this violence. Interviews were conducted with 48 female victims of IPV linked to a male partner's gambling; 24 female victims of IPV linked to their own gambling; and 39 service practitioners from 25 services. Given limited research into gambling-related IPV, but a stronger theoretical base relating to IPV against women, this study used an adaptive grounded theory approach. It engaged with existing theories on gendered drivers of violence against women, while also developing a grounded theory model of individual and relationship determinants based on emergent findings from the data. Gambling-related IPV against women was found to occur in the context of expressions of gender inequality, including men's attitudes and behaviors that support violence and rigid gender expectations, controlling behaviors, and relationships condoning disrespect of women. Within this context, the characteristics of problem gambling and the financial, emotional and relationship stressors gambling causes intensified the IPV. Alcohol and other drug use, and co-morbid mental health issues, also interacted with gambling to intensify the IPV. Major implications. Reducing gambling-related IPV against women requires integrated, multi-level interventions that reduce both problem gambling and gendered drivers of violence. Gambling operators can act to reduce problem gambling and train staff in responding to IPV. Financial institutions can assist people to limit their gambling expenditure and families to protect their assets. Service providers can be alert to the co-occurrence of gambling problems and IPV and screen, treat, and refer clients appropriately. Public education can raise awareness that problem gambling increases the risk of IPV. Reducing gender inequality is also critical.

Associations between sexual identity, living with disability, bully victimisation, and HIV status and intimate partner violence among residents in Nigeria

Background

The aim of the study was to determine the associations between sexual identity, disability and HIV status and bullying victimisation, and a history of physical, emotional and sexual violence in Nigeria.

Methods

This was a secondary analysis of a primary dataset generated through an online survey conducted between February 7 and 19, 2021. The 3197 participants for the primary study were recruited through snowballing. The dependent variables were physical, emotional and sexual violence. The independent variables were sexual identity (heterosexual and sexual minority), HIV status (negative, positive and unknown), bullying victimisation (yes/no) and living with disability (yes/no). A multivariate logistic regression model was developed for each form of IPV. Each model was adjusted for age, sex assigned at birth, marital status and education level.

Results

Respondents living with HIV had higher odds for physical (AOR: 2.01; 95% CI: 1.46–2.76; p < 0.001), sexual (AOR: 2.17; 95%CI: 1.55–3.05; p < 0.001), and emotional (AOR: 1.59; 95%CI: 1.24–2.06; p < 0.001) violence. Also, those with history of bullying victimisation had higher odds for physical (AOR: 3.79; 95%CI: 2.86 – 5.68; p < 0.001), sexual (AOR: 3.05; 95%CI: 2.27 – 4.10; p < 0.001) and emotional (AOR: 2.66; 95%CI: 2.10 – 3.37; p < 0.001) violence. In addition, females had higher odds of physical (AOR: 1.52; 95%CI: 1.13–2.043; p < 0.001) and sexual (AOR: 1.83; 95%CI: 1.34 – 2.50; p < 0.001) violence; and respondents cohabiting (AOR: 1.95; 95%CI: 1.12 – 3.28; p = 0.012) had higher odds for emotional violence. Respondents who were married have significantly lower odds of experiencing physical (AOR: 0.66; 95%CI: 0.45 – 9.60; p = 0.029), sexual (AOR: 0.40; 95%CI: 0.26 – 0.62; p < 0.001) and emotional (AOR: 0.68; 95%CI: 0.50 – 0.93; p = 0.015) violence when compared to singles. Younger respondents also had lower odds of experiencing sexual violence (AOR: 0.97; 95%CI: 0.95–0.99; p = 0.016).

Conclusion

HIV positive status and bullying victimisation seem to increase the risk for all forms of IPV while the experience of IPV did not differ by sexual identity and disability status. The associations between age, sex, marital status and IPV may suggest moderating roles of the factors taking cognisance of the cultural context of these relationships. Future relational analysis is necessary to further understand the pathways for the associations found between the variables in this study.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14186-6.

Prevalence and correlates of intimate partner violence among women with HIV in serodifferent relationships in Nairobi, Kenya

Background

Intimate partner violence (IPV) is a major public health problem and is the most common form of violence against women. Women with HIV in serodifferent relationships may be at an increased risk of IPV compared to women without HIV, hindering their ability to adhere to antiretroviral therapy, clinic appointments, and condom use during sex. This study assessed the prevalence and correlates of IPV in the past year among women with HIV in serodifferent relationships in Nairobi, Kenya.

Methods

This cross-sectional study included women with HIV in serodifferent relationships who were at least 18 years old and provided written informed consent. Their experience of physical, sexual, or emotional violence in the past year by the current partner was assessed using 13 questions adapted from the World Health Organization survey on violence against women. Standardized instruments were used to assess sociodemographic and behavioral factors. Associations between intimate partner violence and other variables were evaluated using log binomial regression models.

Results

Of the 159 women enrolled, 47 (29.6%, 95% CI 22.9–37.2%) reported IPV in the past year. Of these, 32 (68.1%) reported emotional, 27 (57.4%) physical, and 27 (57.4%) sexual violence. In the multivariate model, pregnancy (adjusted prevalence ratio [aPR] 2.14, 95% CI 1.09–4.20), alcohol use (minimal drinking aPR 1.91, 95% CI 1.10–3.33; moderate/severe drinking aPR 1.17, 95% CI 0.53–2.59), male partner controlling behavior (aPR 2.09, 95% CI 1.24–3.51), and past physical violence (aPR 1.93, 95% CI 1.22–3.05) remained significantly associated with a higher prevalence of IPV in the past year.

Conclusion

This study identified a high prevalence of IPV in the past year among women with HIV in serodifferent relationships. Pregnant women and women who had experienced prior violence had a higher prevalence of IPV. These data highlight the need to screen for IPV during clinic visits, and to offer evidence based interventions to support women in serodifferent relationships who have experienced IPV.

Decomposing the gap in intimate partner violence between Scheduled Caste and general category women in India: An analysis of NFHS-5 data

Scheduled Caste (SC) women, one of India's most oppressed and neglected population groups, are the most vulnerable to intimate partner violence (IPV). IPV, on the other hand, is less common among women in the General category. No study has been conducted to measure the gap in IPV between these two groups. This study is an attempt to fill this gap. This study aims to comprehensively explore the factors that underlie and explain the gap in IPV between SC and General women. Information on 10,168 ever-married SC and 9695 ever-married General women aged 15–49 from the fifth round of the National Family Health Survey was analyzed. The Fairlie decomposition (Blinder–Oaxaca decomposition modified for binary outcomes) was used in this study to explain the gap in ever experience of IPV prevalence between SC and General women. About 37.3% and 24.4% of ever-married SC and General women in India suffered either physical or mental or sexual violence from their husbands. The large part of the gap in IPV between SC and General women was due to differences in husbands' alcohol consumption (26.33% gap), wealth index (24.48% gap), controlling behavior by husband (24%) and parental IPV (15.87% gap). With the introduction of appropriate interventions and programs, these gaps can be reduced. Interventions aimed at reducing alcoholism should be emphasized.

•

Intimate Partner Violence (IPV) was more prevalent in Scheduled Caste (SC) women than in General category women.

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Wealth, parental IPV, husband’s alcohol consumption and controlling behavior explained 90% of the SC-General gap in IPV.

•

Group differences in husband’s alcohol consumption explained about one-fourth of the SC-General gap in IPV.

•

Wealth index and husband’s controlling behavior explained about 24.5% and 24.0% of the gap in IPV, respectively.

•

In short run, interventions aimed at reducing alcoholism should be emphasized.

Intimate Partner Violence in the Sub-Saharan African Immigrant Community in Chicago: A Changing Landscape

The challenges of conducting research on intimate partner violence (IPV) in immigrant communities means little is known about the occurrence of various forms of IPV, making it difficult to address in these populations. This research draws on data gathered in Chicago's large and varied African immigrant communities. This research used a mixed methods approach: collection of quantitative survey data on occurrence, followed by qualitative interviews to explain the results. Missing quantitative data and contradicting qualitative responses made it difficult to draw definite conclusions on physical IPV; however, verbal abuse and controlling behaviours appear to be relatively widespread and normalised, and not always viewed as violence. Particularly with the probability of future pandemics and natural disasters, which are known to increase prevalence, it is important to raise awareness of less visible controlling behaviours and verbal abuse as forms of violence, and to implement appropriate prevention programs to minimise a concomitant rise in IPV within African immigrant communities.

Mapping of Intimate Partner Violence: Evidence From a National Population Survey

Evidence on the relative importance of geographical distribution and associated factors with intimate partner violence (IPV) can inform regional and national health programs on women's health. Four thousand seven hundred and twenty married women aged 15-49 years were interviewed in 2016 about IPV and this data was extracted from the Ethiopian Demographic Health Survey (EDHS) in 2020. The sample was selected by a two-staged cluster survey of women. The analysis was conducted using logistic regression that adjusted for clustering and sampling weights. Moreover, weighted proportions of IPV were exported to ArcGIS to conduct autocorrelations to assess the clustering of IPV. Amongst the 4469 married women who were 15 to 49 years of age included in the analysis, 34% (95% CI, 31.4%-36.3%) experienced IPV, 23.5% ( 95% CI, 21.5%-25.7%) experienced physical violence, 10.1% (95% CI, 8.7%- 11.7 %) experienced sexual violence and 24% (95% CI, 21.7%-26.4 %) experienced emotional violence. Partners' controlling behaviour [AOR: 3.94; 95% CI, 3.03- 5.12], partner's alcohol consumption [AOR: 2.59; 95% CI, 1.80- 3.71], partner educational qualifications [AOR: 2.16; 95% CI, 1.26- 3.71], a woman birthing more than five children [AOR: 1.70; 95% CI, 1.12- 2.56] and a history of the woman's father being physically violent towards her mother [AOR: 1.99; 95% CI, 1.52- 2.59] were associated with an increased risk of IPV amongst married women in Ethiopia. Western and Central Oromia, Western Amhara, Gambella and Central Tigray and Hararri were identified as hot spot areas in Ethiopia (p<0.001). In this study, there was a significant geographic clustering of IPV in Ethiopia. Controlling and drinking behaviour and partners' unemployment status were identified as important factors for married women experiencing IPV. Hence, there is a need for a context- driven evidence-based design intervention to reduce the impact of IPV.

Disclosure and help-seeking behaviors related to sexual and physical violence in childhood and adolescence: Results from the Namibia Violence Against Children and Youth Survey

BACKGROUND

Violence disclosure and help-seeking can mitigate adverse health effects associated with childhood violence, but little is known about facilitators and barriers of disclosure and help-seeking behaviors in sub-Saharan Africa.

OBJECTIVE

To understand factors associated with disclosure and help-seeking to inform care.

PARTICIPANTS AND SETTING

Participants aged 13-24 years old in the 2019 Namibia Violence Against Children and Youth Survey (VACS).

METHODS

We assessed the prevalence of victimization, disclosure, and help-seeking and examined factors associated with violence disclosure and help-seeking, separately, by gender.

RESULTS

4211 girls and 980 boys participated in the Namibia VACS. The prevalence of childhood sexual violence differed significantly by gender (15.7% among girls, 9.8% among boys), but physical violence prevalence did not differ by gender. Among victims of sexual violence, 57.3% of girls disclosed and 10.4% sought help, compared with only 30.7% and 3.2% of boys. Among victims of physical violence, 61.1% of girls and 53.4% of boys disclosed, and 16.9% of girls and 17.7% of boys sought help. Older age, social support, and experiencing more types of violence were associated with sexual violence disclosure among boys, but none of these factors were associated with sexual violence disclosure among girls. Lower education, perpetrator type, and witnessing violence were associated with physical violence disclosure among girls, while peer support and perpetrator type were associated with physical violence disclosure among boys.

CONCLUSIONS

Factors associated with childhood violence differed by gender and violence type in Namibia, highlighting a need for gender-specific violence services to facilitate violence disclosure and help-seeking.

Attitude towards negotiating safer sexual relations: Exploring power dynamics among married couples in India

The study primarily focuses on analyzing married women's attitudes towards negotiating safer sex in two contexts. The first context is when a woman refuses to have sex with husband if she knows her husband has a sexually transmitted disease (STD) and the second is when she does so if she knows he has sex with other women. The study examined predictors of Indian women's attitude towards negotiating safer-sex using data on 92,306 ever married women from the state module of the 2015-16, National Family Health Survey 4. Descriptive and multilevel logistic regression was used to understand the interplay between the attitude towards negotiation of safer sexual relationships with husband and the selected background characteristics with a primary focus on controlling behaviour and power relations. About 17% of women did not believe in negotiating safer sexual relations with the husband. An approximately equal proportion of ever-married women (79% each) believed in doing so under the two specific conditions, that is, if they knew the husband had an STD and they knew he had sex with other women. Multilevel regression analysis showed that women who had household decision-making power [AOR=0.71; p<0.01] and those whose husbands displayed low control towards them [AOR=0.91; p<0.05] were more likely to believe in negotiating safer-sex. Our findings suggest that women who have controlling partners or those who live under the umbrella of the husband's authority lack the power to negotiate for safer sex. Interventions promoting sexual well-being must deal with negative male perceptions and expectations that perpetuate unhealthy sexual habits and marriage ties.

AN EXAMINATION OF EFFECTS OF INTIMATE PARTNER VIOLENCE ON CHİLDREN: A CROSS-SECTIONAL STUDY CONDUCTED IN PEDIATRIC EMERGENCY UNIT IN TURKEY

BACKGROUND

Intimate Partner Violence (IPV) against women causes inadequate and unbalanced nutrition in children aged 0-5 years and adversely affects their growth.

AIM

To examine the impact of intimate partner violence on a child's growth regarding the medical diagnosis in paediatric patients under 5-year-old, growth of the child, and mother's exposure to intimate partner violence.

METHODS

This descriptive cross-sectional study included 166 children, admitted to the paediatric emergency department, and their mothers.

RESULTS

Women exposed to emotional violence and controlling behaviour during pregnancy had children prone to being overweight and obese. Mothers' lifetime exposure to physical violence had an adverse effect on their children's wasting and moderate wasting. In contrast, mothers' exposure to emotional violence had a direct impact on childs' wasting and moderate wasting.

CONCLUSION

The lifetime effect of domestic violence may begin at birth. This vulnerability leads to negative outcomes in both children and women regarding biopsychosocial development. Implications for nursing management Nurses and midwives in primary healthcare services and one-on-one care should be trained to evaluate prospective mothers and children aged 0-5 regarding violence and its effects on the child's growth.

A Comparative Assessment of Intimate Partner Violence Perpetration among Male Military Personnel and Civil Servants in Ibadan, Nigeria

The mode of training and work of the military personnel is different from that of civil servants and may affect their relationships with their intimate partners. This study assessed and compared the prevalence and correlates of self-reported Intimate Partner Violence (IPV) perpetration against female partners by male military personnel and civil servants in Ibadan, south-western Nigeria. A cross sectional survey of 1240 respondents, comprising 631 military personnel and 609 civilians, was conducted using a multistage sampling technique. A self-administered questionnaire was used to collect data on the respondents' characteristics and the different types of IPV perpetrated by them. Chi square test was used to compare the proportions of the different types of IPV perpetration and logistic regression analysis was used to determine the predictors of IPV perpetration in the two study groups. Military personnel reported significantly more IPV such as physical abuse, psychological abuse and controlling behaviors than the civil servants. Childhood exposure to inter-parental IPV and history of physical fight with another woman significantly increased the odds of perpetration of each type and any form of IPV in the two populations after controlling for other variables. Military personnel were significantly more likely to perpetrate any form of IPV than the civil servants. IPV was prevalent in both groups but was more among the military personnel. There is a need for multidisciplinary interventions such as psycho-education and conflict management skills to address violence against female intimate partners especially among the military population in Nigeria.

Severity of Lifetime Physical Intimate Partner Violence and Controlling Behavior in Sub-Saharan Africa

Evidence suggests women in sub-Saharan Africa may be more likely to experience intimate partner violence (IPV) than women anywhere else in the world. Data was obtained from women (n = 29,444) who completed the Demographic Health Survey's (DHS) domestic violence module in seven countries in sub-Saharan Africa countries between 2011 and 2015. Women who reported controlling behavior by a spouse/partner were more likely to have experienced less severe lifetime physical violence (adjusted odds ratio (AOR) 3.02, 95% confidence interval (CI) 2.63, 3.47) and severe violence (AOR 4.27, 95% CI 3.32, 5.49). Partner's controlling behavior may increase the likelihood of experiencing both less severe and severe lifetime physical violence.

Intimate Partner Violence Among Women Accessing HIV-Care Services at Tertiary Hospitals in Ogun State, Nigeria: Implications for Policy and Practice

Intimate partner violence is both a predisposing factor for and sequelae of HIV infection. It is more likely for HIV-positive women to experience intimate partner violence compared with HIV-negative women. Previous researches have described the other risk factors for intimate partner violence. This cross-sectional study identified the correlates of intimate partner violence among HIV-positive women accessing HIV-care. We interviewed 458 women accessing HIV-care at the three tertiary hospitals in Ogun State, Nigeria. Trained research assistants conducted 10-min structured interviews with validated questionnaires. We carried out descriptive, bivariate, and regression analyses. We used the backward elimination technique to build a model to predict the experience of intimate partner violence (IPV) within the preceding 12 months. We set the level of significance at .05. A total of 23 (5.02%) participants reported IPV within the preceding 12 months, while the prevalence of lifetime intimate partner violence was 24.02%. Younger age, the experience of IPV in previous relationships, and having multiple sex partners were related to the experience of IPV within the preceding 12 months (p < .05). Also, the partners' age, alcohol intake, and current smoking status were associated with the experience of IPV within the preceding 12 months (p < .05). After regression analysis, participants' age (adjusted odds ratio [AOR] = 0.892, 95% confidence interval [CI] = [0.831, 0.957]), experience of IPV in previous relationship (AOR = 12.841, 95% CI = [4.303, 38.318]), and partners' current smoking status (AOR = 4.874, 95% CI = [1.252, 18.969]) retained association with the experience of IPV within the preceding 12 months. IPV among HIV-positive women accessing HIV-care occurs in a complicated, context-specific way. Routine HIV strategies and services should include interventions that involve men and address gender power imbalances. For effectiveness, specific interventions must consider women's' specific context and characteristics.

Community Attitudes Towards Violence Against Women, and Lived Experiences of Family Violence and Abuse During Childhood in Rural Eastern Nigeria: Implications for Policy and Programming

Background

Violence against women (VAW) has remained an increasingly significant public health problem globally. This study explored childhood experiences of abuse and attitude towards violence against women among adults in a rural community in South-east Nigeria.

Methods

This was a cross-sectional study conducted in a rural community in Ebonyi, Nigeria. Data were collected from 280 respondents using interviewer-administered questionnaires. Data analysis was performed using SPSS version 25.

Results

The mean age of the male participants was 46.5±16.8, while that for the female participants was 43.3±16.9. Most were females (203/280, 72.5%), out of which (83/203, 40.9%) had secondary school as the highest level of education attained. Most participants were females (203/280, 72.5%), married (225/280, 80.4%) with secondary school education (124/280, 44.3%). More than one-tenth (33/280, 11.8%) had ever witnessed parental violence, while 46.4% had been physically abused in childhood. Forced touching and penetrative sex was experienced sometimes by 11.4% (32/280) and 21.8% (61/289), respectively. Overall, the majority (258/280, 92.8%) had a disapproving attitude towards gender-based violence. Most participants disagreed that hitting or insulting woman was not wrong (246/280, 87.9%). The majority of the respondents agreed that women were inferior to men from a cultural perspective (175/280, 62.5%). Almost half strongly agreed (125/2280, 44.6%) and agreed (118/280, 42.1%) that a woman is a man’s possession. The predictors of attitude were secondary school education (AOR = 7.74, 95% CI = 1.69–35.54) and monogamous marital setting (AOR = 2.83, 95% CI = 1.08–7.42).

Conclusion

This study showed that Nigerian adults had high levels of childhood exposures to family violence, physical and sexual abuse. Overall, the majority disapproved of VAW; however, there were gaps that endorsed patriarchal ideologies. Interventions to address VAW should include components targeted at children exposed to violence and de-bunking patriarchal ideologies that encourage VAW.

Predictors of spousal coercive control and its association with intimate partner violence evidence from National Family Health Survey-4 (2015-2016) India

Background

The feminist theory posits that spousal coercive control is not random but a purposeful and systematic men’s strategy to control and dominate their female partners. The frequency of coercive control is more than emotional, physical, and sexual intimate partner violence (IPV). Coercive control is usually mistaken with psychological abuse when it is not and has recently gained independent attention within the spectrum of IPV. The role of socioeconomic factors in determining coercive control and associations between coercive control and form of IPV is less researched.

Objective

We aimed to examine sociodemographic and socioeconomic predictors of spousal coercive control and its association with IPV (past 12-months).

Methods

We analysed data of 66,013 ever-married women aged 15-49 from the National Family Health Survey (NFHS)-4 (2015-2016). Estimates involved bivariate and multivariate logistic regression models, and marginal effects prediction.

Results

The prevalence of spousal coercive control is more commonly reported by 48% of women than the prevalence of IPV 25% (emotional 11%, physical 22%, and sexual 5%) in the past 12 months. Adjusted odds ratio indicate that women having three and more children (aOR 1.1, 95% CI: 1.0-1.2), women work status (1.1; 1.1-1.2), husband’s secondary (1.1; 1.1-1.2) or higher education (1.1; 1.1-1.2), and husband alcohol consumption (1.7; 1.6-1.7) increase the odds of coercive control. In the fully adjusted model coercive control independently increased the likelihood of experiencing emotional (aOR 2.8.; 95% CI: 2.6, 3.1), physical (2.2; 2.1, 2.3), and sexual (2.5; 2.3, 2.8) IPV in the past 12 months; and with an increase in each additional indicator of coercive control acts, the likelihood of physical, sexual, and emotional IPV further increases. When women reported six indicators of coercive control, the predicted proportion of women experiencing emotional 53%, physical 45%, and sexual IPV was 25% in the fully adjusted model.

Conclusion

Coercive control limits women’s social support and contacts contributing to low self-esteem, self-efficacy, and poor mental health. The purpose of this study is to highlight that understudied coercive control is more common than other forms of IPV and is a potential risk factor for physical, sexual, and emotional IPV independently. The inclusion of coercive control in interventions is crucial to prevent form of IPV. Survivals long-term safety and independence can be secured if the current protection law against domestic violence is extended to encompass coercive control.

Postpartum Women's Lived Experiences of Perinatal Intimate Partner Violence in Wolaita Zone, Southern Ethiopia: A Phenomenological Study Approach

Objective

Perinatal intimate partner violence affects the health and safety of postpartum women and their infants. However, it has not been well recognized and addressed in the study setting. Hence, this study aimed to explore postpartum women's lived experiences of perinatal intimate partner violence and its contributing factors in Wolaita Zone, Southern Ethiopia.

Methods

A phenomenological study approach was used to explore postpartum women's lived experiences of perinatal partner violence from January to March 2020. A total of twenty-two postnatal women and five health extension workers (HEWs) were interviewed. Interviews were audio-recorded, transcribed verbatim in local languages, and then translated into English. Data were analyzed thematically, using deductive and inductive coding. The consolidated criteria for reporting qualitative research (CORE-Q) checklist was followed to report the findings.

Results

Results indicated that postpartum women had experienced recurrent violence before, during, and after pregnancy from their husbands, with 16 out of 22 women being subjected to perinatal intimate partner violence. A majority of the participants delineated their exposure to perinatal physical violence next to perinatal psychological violence. Many of the interviewed women noted that violence during pregnancy was exacerbated and increased during postpartum. Moreover, the interviewees revealed that some partners were not only a serious threat to their wives, but also their infants during the postpartum period. Four of the participants stated that their newborns were hit and thrown by their father and became unconscious. Participants linked husbands' perinatal violence with suspicion about the newborn, male-child preference, partner infidelity and jealousy, contraceptives usage, alcohol consumptions, indifference to shortages on household necessities, improper parenting, and financial problems.

Conclusion

This study highlights that postpartum women are experiencing continuous and severe forms of perinatal IPV in the study setting. Thus, community-level interventions that minimize perinatal partner violence against postnatal women and their infants are needed.

Maternal Exposure to Intimate Partner Violence and Child Immunisation: Insights from a Population-based Study in India

Child immunisation is regarded as one of the most essential public health interventions for reducing morbidity and mortality among children. Despite several public healthcare initiatives, a considerable proportion of children are yet to be covered under vaccination service in India. This study attempts to examine the association between maternal exposure to intimate partner violence (IPV) and childhood immunisation in India. Data were drawn from the fourth round of the National Family Health Survey (NFHS-4), conducted in 2015–16. Bivariate and multivariate logistic regression models were employed to assess the associations. About 65% of sample children aged 11–23 months were fully vaccinated. After adjusting for socio-demographic factors, women’s exposure to emotional IPV was significantly associated with a lower likelihood of full immunisation (adjusted odds ratio [AOR]: 0.74, 95% confidence interval [CI]: 0.61–0.90) among children. However, physical and sexual IPV had no significant association with childhood immunisation status in the adjusted analysis. The findings suggest preventive measures against domestic violence to reduce the risk of poor child healthcare services. Furthermore, efforts should be taken for effective reproductive and child healthcare programmes, especially among socio-economically vulnerable women and children, to improve child vaccination coverage.

Development of a women's empowerment index for Tanzania from the demographic and health surveys of 2004-05, 2010, and 2015-16

BACKGROUND

Women's empowerment is a multidimensional construct which varies by context. These variations make it challenging to have a concrete definition that can be measured quantitatively. Having a standard composite measure of empowerment at the individual and country level would help to assess how countries are progressing in efforts to achieve gender equality (SDG 5), enable standardization across and within settings and guide the formulation of policies and interventions. The aim of this study was to develop a women's empowerment index for Tanzania and to assess its evolution across three demographic and health surveys from 2004 to 2016.

RESULTS

Women's empowerment in Tanzania was categorized into six distinct domains namely; attitudes towards violence, decision making, social independence, age at critical life events, access to healthcare, and property ownership. The internal reliability of this six-domain model was shown to be acceptable by a Cronbach's α value of 0.658. The fit statistics of the root mean squared error of approximation (0.05), the comparative fit index (0.93), and the standardized root mean squared residual (0.04) indicated good internal validity. The structure of women's empowerment was observed to have remained relatively constant across three Tanzanian demographic and health surveys.

CONCLUSIONS

The use of factor analysis in this research has shown that women's empowerment in Tanzania is a six-domain construct that has remained relatively constant over the past ten years. This could be a stepping stone to reducing ambiguity in conceptualizing and operationalizing empowerment and expanding its applications in empirical research to study different women related outcomes in Tanzania.

Controlling Behavior and Intimate Partner Violence: A Cross-Sectional Study in an Urban Area of Delhi, India

Intimate partner violence (IPV) is a widespread issue faced by women across the world. While prevalence and epidemiology of IPV has been studied extensively, its association with controlling behavior has been largely ignored. We carried out this study to assess the prevalence of IPV against married women and its association with sociodemographic factors, justification of violence, and controlling behavior by their spouses in Delhi, India. Five hundred women residing in an urban residential area of Delhi, India, responded to a validated questionnaire asking about IPV and controlling behaviors by their husbands. In our study, 30.6% of women had "ever" experienced IPV, and 43.2% women stated that they had experienced controlling behavior by their husbands. Alcohol consumption by the husband, women's justification of their partner's violence, and controlling behavior by the husbands were significantly associated with the experience of IPV among study participants. Women with a lower education status, not financially employed, those who justified violence or faced any form of violence in their marital life were at higher risk of experiencing controlling behavior from their spouses.

Spatial distribution and predictors of domestic violence against women: evidence from analysis of Ethiopian demographic health survey 2016

BACKGROUND

Violence against women particularly that is committed by an intimate partner is becoming a social and public health problem across the world. Studies show that the spatial variation in the distribution of domestic violence was commonly attributed to neighborhood-level predictors. Despite the prominent benefits of spatial techniques, research findings are limited. Therefore, the current study intends to determine the spatial distribution and predictors of domestic violence among women aged 15-49 in Ethiopia.

METHODS

Data from the Ethiopian demographic health survey 2016 were used to determine the spatial distribution of domestic violence in Ethiopia. Spatial auto-correlation statistics (both Global and Local Moran's I) were used to assess the spatial distribution of domestic violence cases in Ethiopia. Spatial locations of significant clusters were identified by using Kuldorff's Sat Scan version 9.4 software. Finally, binary logistic regression and a generalized linear mixed model were fitted to identify predictors of domestic violence.

RESULT

The study found that spatial clustering of domestic violence cases in Ethiopia with Moran's I value of 0.26, Z score of 8.26, and P value < 0.01. The Sat Scan analysis identifies the primary most likely cluster in Oromia, SNNP regions, and secondary cluster in the Amhara region. The output from regression analysis identifies low economic status, partner alcohol use, witnessing family violence, marital controlling behaviors, and community acceptance of wife-beating as significant predictors of domestic violence.

CONCLUSION

There is spatial clustering of IPV cases in Ethiopia. The output from regression analysis shows that individual, relationship, and community-level predictors were strongly associated with IPV. Based upon our findings, we give the following recommendation: The government should give prior concern for controlling factors such as high alcohol consumption, improper parenting, and community norm that encourage IPV that were responsible for IPV in the identified hot spot areas.

R.E.S.P.e.c.T and intimate partner violence: a cross-sectional study using DHS data in Kenya

BACKGROUND

Thirty per cent of all women experience intimate partner violence (IPV) in their lifetime. The aim of this study was to examine the association between the WHO's novel R.E.S.P.E.C.T framework and IPV among women in Kenya.

METHODS

We used the 2014 Kenya Demographic and Health Survey (KDHS). Only women selected for the domestic violence module and who were married/living with their partner were eligible for this study (n=3737). We created a summary score for the strategies denoted by R.E.S.P.T based on availability of questions addressing these strategies in the KDHS, and a total score that summed responses across all strategies. Each letter was assessed with Cronbach's alpha. Multiple logistic regression models were used to investigate the relationship between R.E.S.P.T scores and IPV.

RESULTS

All strategies except for E lowered the odds of IPV. Decision-making (R) was negatively associated with experiencing IPV (OR=0.62 (0.53 to 0.72)). Land and property ownership (E) were positively associated with experiencing IPV (OR=1.25 (1.08 to 1.43)). Access to healthcare (S) was negatively associated with experiencing IPV (OR=0.55 (0.48 to 0.63)). Higher levels of wealth (P) were negatively associated with experiencing IPV (OR=0.47 (0.37 to 0.62)). Not justifying wife-beating in any scenario (T) was negatively associated with experiencing IPV (OR=0.39 (0.29 to 0.53)). After adjusting for demographics, a 1-unit increase in total R.E.S.P.T score was negatively associated with experiencing IPV (AOR=0.63 (0.57 to 0.70)) with a similar finding for IPV in the past 12 months (AOR=0.59 (0.53 to 0.66)). Younger women, higher education and Muslim religion were associated with decreased odds of experiencing IPV while living in a rural location and working were associated with increased odds of experiencing IPV.

CONCLUSIONS

Our study provides initial evidence that by using the multistrategy R.E.S.P.E.C.T framework, countries can dramatically lower the odds of women experiencing IPV. IPV prevention strategies must have a wide approach. The DHS can be used as a tool to monitor implementation and efficacy of this novel strategy.

Toward Community Coverage on Self-Screening, Diagnosis, and Help-Seeking Behavior for Both Gender Victims of Intimate Partner Violence (IPV) in a Kenyan Setting: The Development of IPV-Brief Self-Screener (IPV-BSS) Version of the WHO-IPV Instrument

Intimate partner violence (IPV) is a major public health concern. The prevalence of IPV in women in Kenya is in the range of 41% to 45% but has also been reported in 20% of men. The most widely used instrument for the screening and diagnosis of IPV is the World Health Organization-Intimate Partner Violence (WHO-IPV). However, it is lengthy for routine large-scale screening and is administered by a trained person, thus limiting the number it can reach for screening. There is therefore a need for a shorter screening version that can be self-administered to reach critical masses. Those who screen positive can then be subjected to the longer version. In addition, the short version should be culturally sensitive, can be used by either gender, can be used in busy clinical settings as the patients wait to be attended to, and can be used for large-scale community populations to raise awareness and promote help-seeking behavior. It should be applicable in similar cultural settings and is aligned to the longer version of the WHO-IPV instrument. This study aimed to develop such a tool. We administered the WHO-IPV to two groups: firstly, postnatal mothers attending postnatal clinics and secondly, men and women attending general clinics to which they had been referred. These referrals were by traditional healers (TH), faith healers (FH), and community health workers (CHW) who had been trained to screen for mental disorders using the Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG) master checklist. Using factor analysis of the scores, we came up with questions that had the highest predictive value for different types of IPV diagnosis and which could therefore be used for self-screening purposes. We call the tool the Intimate Partner Violence-Brief Self-Screener (IPV-BSS; Adapted by the Africa Mental Health Research and Training Foundation from the WHO-IPV).

Bayesian semi-parametric spatial modelling of intimate partner violence in Namibia using 2013 Demographic Health Survey Data

BACKGROUND

Intimate partner violence (IPV) is an important public health problem with health and socioeconomic consequences and is endemic in Namibia. Studies assessing risk factors for IPV often use logistic and Poisson regression without geographical location information and spatial effects. We used a Bayesian spatial semi-parametric regression model to determine the risk factors for IPV in Namibia; assess the non-linear effects of age difference between partners and determine spatial effects in the different regions on IPV prevalence.

METHODS

We used the couples' dataset of the 2013-2014 Namibia Demographic and Health Survey (DHS) obtained on request from Measure DHS. The DHS domestic violence module included 2226 women. We generated a binary variable measuring IPV from the questions "ever experienced physical, sexual or emotional violence?" Covariates included respondent's educational level, age, couples' age difference, place of residence and partner's educational level. All estimation was done with the full Bayesian approach using R version 3.5.2 implementing the R2BayesX package.

RESULTS

IPV country prevalence was 33.3% (95% CI = 30.1-36.5%); Kavango had the highest [50.6% (95% CI = 41.2-60.1%)] and Oshana the lowest [11.5% (95% CI = 3.2-19.9%)] regional prevalence. IPV prevalence was highest among teenagers [60.8% (95% CI = 36.9-84.7%)]). The spatial semi-parametric model used for adjusted results controlled for regional spatial effects, respondent's age, age difference, respondent's years of education, residence, wealth, and education levels. Women with higher education were 50% less likely to experience IPV [aOR: 0.46, 95% CI = 0.23-0.87]. For non-linear effects, the risk of IPV was high for women ≥ 5 years older or ≥ 25 years younger than their partners. Younger and older women had higher risks of IPV than those between 25 and 45 years. For spatial variation of IPV prevalence, northern regions had low spatial effects while western regions had very high spatial effects.

CONCLUSION

The prevalence of IPV among Namibia women was high especially among teenagers, with higher educational levels being protective. The risk of IPV was lower in rural than urban areas and higher with wide partner age differences. Interventions and policies for IPV prevention in Namibia are needed for couples with wide age differences as well as for younger women, women with lower educational attainment and in urban and western regions.

Perpetration and Experience of Spousal Violence Among Nigerian Women: An Analysis of the 2008 and 2013 NDHS

Various socioeconomic and demographic factors have been known to be associated with spousal violence. The intimate partner violence (IPV) experiences of Nigerian women have been investigated from feminist and life course perspectives from previous studies. However, studies have also pointed to the complexities of victimhood with the presence of IPV perpetration. But there have been few studies on the impact of perpetration of violence on the experience of victimization, and this study seeks to address that gap in knowledge within the Nigerian context. It seeks to understand the dynamics of perpetration and the experience of spousal violence among Nigerian women across 2008 and 2013. The study analyzed the 2008 and 2013 Nigerian Demographic Health Survey (NDHS) data. Using binary logistic regression, the study showed that the perpetration of violence is significantly associated with a woman's victimization experience, after controlling for socioeconomic, demographic, and abuse variables in 2008 and 2013. This study does not in any way minimize the victimization experiences of Nigerian women but simply seeks to provide data that add nuance to our understanding of spousal violence and the possible existence of bidirectional violence among Nigerian spouses.

Controlling Behavior and Lifetime Physical, Sexual, and Emotional Violence in sub-Saharan Africa

Intimate partner violence (IPV), commonly accompanied by controlling behavior, is a serious public health concern in sub-Saharan Africa. Data from women (n = 37,115) aged 15 to 49 years who completed the Demographic Health Survey's (DHS) domestic violence module in eight countries in sub-Saharan Africa (Cameroon, Democratic Republic of the Congo [DRC], Côte d'Ivoire, Namibia, Rwanda, Sierra Leone, Togo, and Zambia) between 2011 and 2015 were obtained. DHS questions assessed lifetime physical, emotional, and sexual violence (ever vs. never). Controlling behavior was measured by a revised Conflict Tactics Scale. Multivariate logistic regression examined the association between controlling behavior and IPV adjusting for all covariates, including age, education, marital status, wealth, urban/rural setting, and occupation. An interaction term was included to evaluate the consistency of effect estimates across countries. In all, 45.60% of women reported experiencing one or more forms of IPV (physical, sexual, or emotional violence) in their lifetime, ranging from 31.16% in Côte d'Ivoire to 57.37% in Cameroon. Women who reported controlling behavior by a spouse/partner were more likely to have experienced lifetime physical (adjusted odds ratio [AOR] = 3.57, 95% confidence interval [CI] = [3.31, 3.85], sexual (AOR = 3.98, CI = [3.47, 4.57]) or emotional (AOR = 3.52, CI = [3.22, 3.85]) violence than women who did not report controlling behavior. Women who reported controlling behavior were also more likely to have experienced one (AOR = 2.57, CI = [2.36, 2.81]) or two/three types (AOR = 5.34, CI = [4.80, 5.94]) of violence. AORs did not significantly differ across countries. Further research is needed to evaluate whether policies, programs, and education aimed at preventing or modifying controlling behavior may reduce IPV.

Addressing Intimate Partner Violence Using Gender-Transformative Approaches at a Community Level in Rural Tanzania: The UZIKWASA program

Intimate partner violence (IPV) is recognized as an important public health and social problem, with far-reaching consequences for women's physical and emotional health and social well-being, yet little is known about how behavior change campaigns (BCCs) affect this type of behavior and other related abuses in Tanzania and in other sub-Saharan African countries. UZIKWASA is a civil society organization based in Pangani District in coastal Tanzania and since 2009 has conducted BCCs focused on promoting gender justice and effective leadership. As with other complex programs there is a question about how such approaches affect norms and practice in relation to violence against women and girls. Drawing on longitudinal research utilizing more than 1000 community diary entries (hearsay ethnographies) and qualitative methods using 20 in-depth interviews and 16 focus group discussions with women and men, and adolescent girls and boys, this article explores the ways in which UZIKWASA's program effects change. The findings reveal personal and community narratives about gender-based and IPV as forms of retributive justice and assertion of authority by men. Drawing on gender performance as an explanation for violence, the research revealed changes in norms and practice in relation to violence against women and girls. Thus, we argue that UZIKWASA is gender-transformative by addressing gender norms and the critical awareness among leaders and the community of the social construction and reconstruction of gender that creates the context for real impact on changes in behavior.

Exposure to domestic violence and the risk of developing depression within 6 months postpartum in Bangladesh

PURPOSE

Domestic violence (DV) by husbands or in-laws is a recognized problem in many countries and is associated with a wide range of adverse mental health outcomes. However, detailed knowledge on the relationship between DV experience and postpartum depression (PPD) is essential to design appropriate interventions. Therefore, this study assesses the relationship between maternal experience of DV perpetrated by husbands or in-laws and PPD in Bangladesh.

METHODS

A cross-sectional survey was conducted from October to December 2019 among 497 mothers within the first 6 months postpartum who attended a health center in Rajshahi City Corporation, Bangladesh. Multivariable logistic regressions were performed to identify the associations after controlling for potential confounders.

RESULTS

The prevalence of PPD in this sample was 34% within the first 6 months after birth; 58.6% of mothers reported having experienced any form of DV in their lifetime. Maternal experience of any form of DV (Adjusted Odds Ratio [AOR] = 1.87; 95% confidence interval [CI] = 1.19-2.93) was associated with PPD, as were experiences of any physical DV (AOR = 2.25; 95% CI = 1.40-3.59), emotional DV (AOR = 2.07; 95% CI = 1.34-3.19), and controlling behavior (AOR = 1.69; 95% CI = 1.08-2.66). Additionally, the likelihood of PPD significantly increased among women who experienced more forms of DV.

CONCLUSION

DV perpetrated by husband and/or in-laws is highly prevalent and significantly associated with PPD in Bangladesh. Strategies in developing interventions for improving maternal mental health should consider DV perpetrated by either husband or in-laws.

Investigating the relationship between women's experience of intimate partner violence and utilization of maternal healthcare services in India

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.

Determination of the factors affecting sexual violence against women in Turkey: a population-based analysis

Background

Sexual violence is one of the most investigated types of violence by national and international decision makers. The purpose of this study was to detect the factors that affect sexual violence against women in Turkey.

Methods

In this study, a cross-sectional data set was employed from the survey titled the National Research on Domestic Violence against Women in Turkey, which was conducted by the Hacettepe University Institute of Population Studies. Binary logistic and probit regression analyses were used to determine the factors influential in women’s exposure to sexual violence.

Results

The findings obtained from the analyses indicated that women’s exposure to sexual violence was influenced by a variety of factors including region, age, level of education, employment status, health condition, marital status, number of children as well as exposure to physical, economic, and verbal abuse. In addition, it was determined that the level of education, employment status, drug use, infidelity and other variables related to the husband/partner of the women who participated in the survey affected the women’s exposure to sexual violence.

Conclusion

There remains a higher probability of exposure to sexual violence among women residing in rural and less developed regions. A decrease in the women’s level of education increased their probability of exposure to sexual violence. An increase in the women's age and an increase in the level of education of the women’s husbands/partners lowered the probability of their exposure to sexual violence. There was a higher probability of exposure to sexual violence among women who had experienced physical, economic, and verbal abuse.

Is Women's Tendency to Negotiate Safer Sex Another Opportunity for Intimate Partner Violence in Nigeria?

Husband's controlling and domineering attitudes have been shown to contribute to women's intimate partner violence experience in Nigeria. Some scholars have suggested that women's safer sex negotiation may create additional opportunity for incurring partner violence. The purpose of the current study was to test the possibility that married women's tendency to negotiate safer sex would contribute significant additional proportions of the variance in their experience of physical, sexual, and emotional violence. Using nationally representative data from a sample of married women in Nigeria (N = 19,360), three separate hierarchical regression analyses were performed to examine the contributions of husband's controlling and domineering attitudes and tendency to negotiate safer sex to the three types of violence experience. Regression analyses revealed that women whose husbands endorsed more controlling and domineering attitudes experienced more physical, sexual, and emotional violence. Furthermore, women with higher tendency to negotiate safer sex experienced more of all the forms of violence. After accounting for the influence of husband's controlling and domineering attitudes, regression analyses revealed that women's tendency to negotiate safer sex accounted for significant additional contributions of the variance in physical, sexual, and emotional violence experience. The additional contributions suggest that specific interventions may be needed for improving women's negotiation skills to reduce husband perpetrated violence risk.

Participation in household decision making and justification of wife beating: evidence from the 2018 Mali Demographic and Health Survey

Background

We assessed the association between women's participation in household decision making and justification of wife beating among married women ages 15–49 y in Mali.

Methods

We employed a cross-sectional study design among 7893 women of reproductive age involving a two-stage sampling technique using version 6 of the Mali Demographic and Health Survey (MDHS) data, which was conducted in 2018.

Results

Approximately 37% participated in at least one household decision while 23.4% reported that they would not justify wife beating in any of the stated circumstances. Women who participated in at least one household decision had lower odds (adjusted odds ratio [AOR] 0.834 [confidence interval {CI} 0.744 to 0.935]) of justifying wife beating. With respect to the covariates, we found that women 45–49 y of age had lower odds of justifying wife beating compared with those ages 15–19 y (AOR 0.569 [CI 0.424 to 0.764]). Women with higher education (AOR 0.419 [CI 0.265 to 0.662]) and those whose husbands had secondary education (AOR 0.825 [CI 0.683 to 0.995]) had lower odds of justifying wife beating. Women who lived in urban areas were less likely to justify wife-beating (AOR 0.328 [CI 0.275 to 0.390]) compared with those who lived in rural areas.

Conclusion

This study suggests that participation in household decision making is associated with a significantly lower rate of justifying wife beating in Mali. These results underscore the need for various interventions to empower women to increase women's participation in decision making to reduce justification of domestic violence.