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Slavin MN, West BS, Schreiber-Gregory D, Levin FR, Wingood G, Martino S, Tzilos Wernette G, Black C, El-Bassel N. Correlates of Unmet Need for Modern Contraception Among Reproductive-Aged Women Involved in New York City Criminal Legal Systems. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:132-142. [PMID: 38404679 PMCID: PMC10890951 DOI: 10.1089/whr.2023.0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/27/2024]
Abstract
Introduction The population of women involved in criminal legal systems (WICL), a majority of whom are reproductive-aged, has risen steadily in the United States. They contend with numerous barriers to sexual and reproductive health services resulting in high rates of unmet need for contraception and unintended pregnancy. Materials and Methods This study included 132 non-pregnancy seeking reproductive-aged WICL enrolled in the baseline assessment of the HIV prevention intervention, "Women on the Road to Health" (WORTH). A multivariate generalized linear logistic regression model with robust estimation examined effects of past 6-month intimate partner violence (IPV; sexual and physical/injurious), past 3-month substance use (binge drinking, cannabis, other illegal drug use), and lifetime mental health diagnoses (anxiety, depression, bipolar disorder) on women's unmet need for modern contraception, adjusting for significant demographic and socioeconomic factors. Results Women who were younger in age (odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.63-0.88) and reporting lifetime diagnoses of anxiety disorders (OR: 13.64; 95% CI: 2.71-68.34) were significantly more likely to meet the criteria for unmet need for modern contraception. Women with a regular gynecologist (OR: 0.11; 95% CI: 0.01-0.86) reporting lifetime diagnoses of bipolar disorder and past 6-month sexual IPV histories (OR: 0.04; 95% CI: 0.002-0.86) were significantly less likely to meet the criteria for unmet need for modern contraception. Conclusions Distinct mental health diagnoses and experiences of IPV may uniquely impact unmet need for modern contraception among WICL. These findings emphasize the need for a more nuanced comprehension of these relationships to deliver comprehensive and holistic health services that address the intersecting needs of this population. Trial registration: ClinicalTrials.gov NCT01784809. Registered 6 February 2013.
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Affiliation(s)
- Melissa N. Slavin
- School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, New Jersey, USA
| | - Brooke S. West
- Social Intervention Group, Columbia School Social Work, Columbia University, New York, New York, USA
| | | | - Frances R. Levin
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, Columbia University, New York, New York, USA
| | - Gina Wingood
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Steve Martino
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Golfo Tzilos Wernette
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Chermaine Black
- Social Intervention Group, Columbia School Social Work, Columbia University, New York, New York, USA
| | - Nabila El-Bassel
- Social Intervention Group, Columbia School Social Work, Columbia University, New York, New York, USA
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Wedajo LF, Mamo AM, Alemu SS, Mesfin BA. Extended postpartum intimate partner violence and its associated factors: community-based cross-sectional study design. BMC Womens Health 2023; 23:501. [PMID: 37730570 PMCID: PMC10512573 DOI: 10.1186/s12905-023-02649-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Intimate partner violence is a global problem that threatens mothers. It has multidimensional consequences but has not gained attention from scholars after childbirth. OBJECTIVE To assess the prevalence of extended postpartum intimate partner violence and its associated factors. METHOD A community-based cross-sectional study design was employed among 570 postpartum mothers in Arba Minch Town, Southern Ethiopia, from May 21st to June 21st, 2022. A pretested, face-to-face interviewer-administered structured questionnaire was used. Bivariable and multivariable logistic regression analyses were used. The level of statistical significance was declared at P < 0.05 with a 95% CI. RESULTS Overall, the prevalence of extended postpartum intimate partner violence was 45% (95% CI: 40.89, 49.20). Participants whose husband has no formal education (AOR = 3.62; 95%CI: 1.32, 9.90) and only secondary education (AOR = 2.96; 95%CI: 1.56, 5.48), husband alcohol consumption (AOR = 1.73; 95%CI: 1.06, 2.80), husband dominance in decision-making (AOR = 1.94; 95%CI: 1.13, 3.33), husband disappointment in the gender of the baby (AOR = 2.13; 95%CI: 1.28, 3.56), previous history of intimate partner violence (AOR = 5.71; 95%CI: 3.59, 9.07), and low social support (AOR = 4.37; 95%CI: 2.53, 7.55) were significantly associated factors. CONCLUSIONS AND RECOMMENDATIONS The prevalence of extended postpartum intimate partner violence was found to be high. Thus, increasing awareness of husbands with no formal education and having lower academic achievement, incorporating maternal social support assessment into maternity and child health care; teaching on alcohol reduction behavior and gender roles; and screening of mothers during the prenatal period should be given.
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Affiliation(s)
- Lema Fikadu Wedajo
- Department of Midwifery, College of medical and Health Sciences, Mettu University, Metu, Ethiopia.
| | - Abera Mersha Mamo
- Departments of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Solomon Seyife Alemu
- Department of Midwifery, College of medical and Health Sciences, Mettu University, Metu, Ethiopia
| | - Bezawit Afework Mesfin
- Departments of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Amel Barez M, Mirzaii Najmabadi K, Latifnejad Roudsari R, Mosavi Bazaz M, Babazadeh R. "Family and society empowerment": a content analysis of the needs of Iranian women who experience domestic violence during pregnancy: a qualitative study. BMC Womens Health 2023; 23:370. [PMID: 37438772 PMCID: PMC10339606 DOI: 10.1186/s12905-023-02525-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/03/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Domestic violence threatens maternal physical, psychological and emotional safety. Victim/survivor pregnant women required interventions based on their actual needs with the purpose of reducing domestic violence and its negative consequences. The present study aimed to explore the experiences of victimized Iranian pregnant women and identify their neglected needs. METHODS This qualitative descriptive study was performed from September 2019 to August 2021 in Mashhad, Iran. Semi-structured interviews with 14 women (8 pregnant and 6 after birth) who were the victims of domestic violence, and 11 key informants with various discipline specialties until the data saturation was achieved. Participants were selected through purposive sampling. Qualitative data were analyzed based on the conventional content analysis adopted by Graneheim & Lundman. FINDINGS The main theme emerging from the data analysis was "family and society empowerment" that implied the necessity of family, health system, legal, social and inter sectoral empowerment to reduce domestic violence during pregnancy. "Family and society empowerment" was comprised of three categories such as "need to empower couples to reduce domestic violence during pregnancy", "demand for improved health care services", and "need to strengthen inter-sectoral, legal and social supports". CONCLUSION Victim/survivor pregnant women experienced individual, interpersonal and inter sectoral needs. Family and society empowerment constituted the actual needs of victimized pregnant women. Awareness of policymakers and health system managers of these needs could be the basis for designing a supportive care program according to victim/survivor women's actual needs. In addition to the educational and skill empowerment of couples, it is essential that supportive organizations cooperate with each other to provide integrated and coordinated services to victim/survivor pregnant women and strengthen and facilitate their access to supportive resources.
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Affiliation(s)
- Malikeh Amel Barez
- Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
| | | | | | - Mojtaba Mosavi Bazaz
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Raheleh Babazadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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Ahinkorah BO, Aboagye RG, Seidu AA, Boadu Frimpong J, Hagan JE, Budu E, Yaya S. Physical violence during pregnancy in sub-Saharan Africa: why it matters and who are most susceptible? BMJ Open 2023; 13:e059236. [PMID: 37369400 PMCID: PMC10410895 DOI: 10.1136/bmjopen-2021-059236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/20/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE The study assessed the prevalence of physical violence against pregnant women and its associated factors in sub-Saharan Africa (SSA). DESIGN We analysed cross-sectional data of 108971 women in sexual unions from the most recent Demographic and Health Surveys of 26 countries in SSA. The predictors of physical violence were examined using a multilevel binary logistic regression. All the results were presented as adjusted odds ratios (aORs) with their corresponding 95% confidence intervals (CIs). SETTING Twenty-six countries in SSA. PARTICIPANTS 108 971 women who had ever been pregnant. OUTCOME MEASURE Physical violence during pregnancy. RESULTS Physical violence was identified in 6.0% of pregnant women in SSA. The highest prevalence (14.0%) was reported in South Africa, while Burkina Faso recorded the lowest (2.1%). Women who had primary (aOR=1.26, 95% CI=1.15, 1.38) and secondary education (aOR=1.15, 95% CI=1.01,1.32); those who were cohabiting (aOR=1.21, 95% CI=1.11, 1.32); those who were working (aOR=1.17, 95% CI=1.08, 1.28); and those whose partners had primary (aOR=1.15, 95% CI=1.04, 1.28) and secondary education (aOR=1.14, 95% CI=1.01, 1.28) were more likely to experience physical violence during pregnancy compared with those who had no formal education; those who were married; those who were not working, and those whose partners had no formal education, respectively. Moreover, women whose partners consumed alcohol (aOR=2.37, 95% CI=2.20, 2.56); those who had parity of four or more (aOR=2.06, 95% CI=1.57, 2.72); and those who perceived intimate partner violence (IPV) as a culturally accepted norm (aOR=1.55, 95% CI=1.44, 1.67) had higher odds of experiencing physical violence during pregnancy compared to those whose partners did not consume alcohol, those with parity zero, and those who did not perceive IPV as culturally accepted, respectively. On the contrary, women who were aged 35-39, those who were of the richest wealth index, and those in rural areas had reduced odds of experiencing physical violence during pregnancy. CONCLUSION Based on the findings, community leaders are encouraged to liaise with law enforcement agencies to strictly enforce laws on gender-based violence by prosecuting perpetrators of IPV against pregnant women as a deterrent. Also, intensifying education on what constitutes IPV and the potential consequences on the health of pregnant women, their children, and their families will be laudable. Improving the socioeconomic status of women may also help to eliminate IPV perpetration against women at their pregnancy stage.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Sharma R, Kaphle HP. Intimate partner violence during pregnancy among married women in Putalibajar municipality, Nepal. Front Psychol 2023; 14:1158406. [PMID: 37359874 PMCID: PMC10286819 DOI: 10.3389/fpsyg.2023.1158406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Intimate partner violence during pregnancy (IPVDP) is increasingly being recognized as a significant problem in the developing world due to its adverse health consequences on both pregnant women and children. The objective of the study is to measure the magnitude of intimate partner violence during pregnancy and the factors associated with IPVDP. Methods A community-based cross-sectional study was conducted among 263 married women in their extended postpartum period between October 2019 and March 2020 in Putalibajar municipality, Nepal. A face-to-face interview was conducted and data were collected using an interview schedule. A Chi-square test and logistic regression analysis were performed to examine the association between IPVDP and the independent variables. Results Among the 263 women interviewed, 30% experienced IPV during pregnancy, the most common type of violence was controlling behavior (20.2%) followed by emotional (18.6%), sexual (10.6%), economic (6.1%), and physical violence (5.3%). It was observed that IPV was more likely to occur among women whose husbands consumed alcohol (AOR = 3.171; CI 95%: 1.588-9.167), women whose husbands consumed tobacco (AOR =3.815; CI 95%: 2.157-7.265), women who sometimes received family support during pregnancy (AOR =2.948; CI 95%: 1.115-7.793) and women who did not decide on marriage timing (AOR =2.777; CI 95%: 1.331-5.792). Conclusion Three out of ten pregnant women experienced IPVDP. To prevent violence, and ensure women's empowerment, formulating strict laws and discouraging the element of a violent milieu is important.
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Okedare OO, Fawole OI. Intimate partner violence among young women in Ibadan, Nigeria: are there slum and non-slum differences? BMC Womens Health 2023; 23:290. [PMID: 37244999 PMCID: PMC10224597 DOI: 10.1186/s12905-023-02446-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 05/19/2023] [Indexed: 05/29/2023] Open
Abstract
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.
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Affiliation(s)
- Omowumi O Okedare
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria.
| | - Olufunmilayo I Fawole
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
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Mehra D, Srivastava S, Chandra M, Srivastava N, Laaksonen M, Saarinen HE, Mehra S. Effect of physical mobility, decision making and economic empowerment on gender-based violence among married youth in India-SAWERA project. BMC Public Health 2023; 23:548. [PMID: 36959579 PMCID: PMC10034242 DOI: 10.1186/s12889-023-15421-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
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.
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Affiliation(s)
- Devika Mehra
- grid.503716.60000 0004 1766 9202MAMTA Health Institute for Mother and Child, New Delhi, India
- grid.4514.40000 0001 0930 2361Division of Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Shobhit Srivastava
- grid.503716.60000 0004 1766 9202MAMTA Health Institute for Mother and Child, New Delhi, India
| | - Murari Chandra
- grid.503716.60000 0004 1766 9202MAMTA Health Institute for Mother and Child, New Delhi, India
| | - Namita Srivastava
- grid.503716.60000 0004 1766 9202MAMTA Health Institute for Mother and Child, New Delhi, India
| | | | | | - Sunil Mehra
- grid.503716.60000 0004 1766 9202MAMTA Health Institute for Mother and Child, New Delhi, India
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Sabri B, Rai A, Rameshkumar A. Violence Against Women in India: An Analysis of Correlates of Domestic Violence and Barriers and Facilitators of Access to Resources for Support. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2022; 19:700-729. [PMID: 36530195 PMCID: PMC9756932 DOI: 10.1080/26408066.2022.2105671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Purpose Domestic violence (DV) is a significant public health problem in India, with women disproportionately impacted. This study a) identified risk and protective correlates of DV and, b) barriers and facilitators for seeking and receiving help for DV among women in India. Methods A systematic search of 5 databases was performed to identify correlates of DV in the quantitative literature. The search resulted in inclusion of 68 studies for synthesis. For qualitative exploration, data were collected from 27 women in India. Results While factors such as social norms and attitudes supportive of DV were both risk correlates and barriers to addressing DV, omen's empowerment, financial independence and informal sources of support were both protective correlates of DV as well as facilitators in addressing DV. Conclusions Strong efforts in India are needed to reduce DV-related risk factors and strengthen protective factors and enhance access to care for women in abusive relationships.
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Affiliation(s)
- Bushra Sabri
- John Hopkins University School of Nursing, Baltimore, MD
| | - Abha Rai
- School of Social Work, Loyola University, Chicago, IL
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Chowdhury S, Singh A, Kasemi N, Chakrabarty M. Decomposing the gap in intimate partner violence between Scheduled Caste and general category women in India: An analysis of NFHS-5 data. SSM Popul Health 2022; 19:101189. [PMID: 35990408 PMCID: PMC9382320 DOI: 10.1016/j.ssmph.2022.101189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 07/15/2022] [Accepted: 07/23/2022] [Indexed: 11/26/2022] Open
Abstract
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. 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.
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Riley A, Daruwalla N, Kanougiya S, Gupta A, Wickenden M, Osrin D. Intimate partner violence against women with disability and associated mental health concerns: a cross-sectional survey in Mumbai, India. BMJ Open 2022; 12:e056475. [PMID: 35477887 PMCID: PMC9047698 DOI: 10.1136/bmjopen-2021-056475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 02/15/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The risk of intimate partner violence (IPV) against women with disability is believed to be high. We aimed to compare the prevalence of past-year IPV against women with and without functional difficulties in urban informal settlements, to review its social determinants and to explore its association with mental health. DESIGN Cross-sectional survey. SETTING Fifty clusters within four informal settlements. PARTICIPANTS 5122 women aged 18-49 years. PRIMARY AND SECONDARY OUTCOME MEASURES We used the Washington Group Short Set of Questions to assess functional difficulties. IPV in the past year was described by binary composites of questions about physical, sexual and emotional violence. We screened for symptoms of depression using the Patient Health Questionnaire-9 and of anxiety using the Generalised Anxiety Disorder-7. Multivariable logistic regression models examined associations between functional difficulties, IPV and mental health. RESULTS 10% of participants who screened positive for functional disability had greater odds of experiencing physical or sexual IPV (adjusted OR (AOR) 1.68, 95% CI 1.23 to 2.29) and emotional IPV (1.52, 95% CI 1.16 to 2.00) than women who screened negative. Women who screened positive for functional disability had greater odds than women who screened negative of symptoms suggesting moderate or severe anxiety (AOR 2.50, 95% CI 1.78 to 3.49), depression (2.91, 95% CI 2.13 to 3.99) and suicidal thinking (AOR 1.94, 95% CI 1.50 to 2.50). CONCLUSIONS The burden of IPV fell disproportionately on women with functional difficulties, who were also more likely to screen positive for common mental disorder. Public health initiatives need to respond at local and national levels to address the overlapping and mutually reinforcing determinants of violence, while existing policy needs to be better utilised to ensure protection for the most vulnerable.
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Affiliation(s)
- Andrew Riley
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Nayreen Daruwalla
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra, India
| | - Suman Kanougiya
- Tata Institute of Social Sciences (TISS), Mumbai, Maharashtra, India
| | - Apoorwa Gupta
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra, India
| | - Mary Wickenden
- Institute of Development Studies, University of Sussex, Brighton, UK
| | - David Osrin
- Institute for Global Health, University College London, London, UK
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Batura N, Poupakis S, Das S, Bapat U, Alcock G, Skordis J, Haghparast-Bidgoli H, Pantvaidya S, Osrin D. Factors associated with women's healthcare decision-making during and after pregnancy in urban slums in Mumbai, India: a cross-sectional analysis. BMC Public Health 2022; 22:743. [PMID: 35418068 PMCID: PMC9009007 DOI: 10.1186/s12889-022-13216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 04/07/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Understanding factors associated with women's healthcare decision-making during and after pregnancy is important. While there is considerable evidence related to general determinants of women's decision-making abilities or agency, there is little evidence on factors associated with women's decision-making abilities or agency with regards to health care (henceforth, health agency), especially for antenatal and postnatal care. We assessed women's health agency during and after pregnancy in slums in Mumbai, India, and examined factors associated with increased participation in healthcare decisions. METHODS Cross-sectional data were collected from 2,630 women who gave birth and lived in 48 slums in Mumbai. A health agency module was developed to assess participation in healthcare decision-making during and after pregnancy. Linear regression analysis was used to examine factors associated with increased health agency. RESULTS Around two-thirds of women made decisions about perinatal care by themselves or jointly with their husband, leaving about one-third outside the decision-making process. Participation increased with age, secondary and higher education, and paid employment, but decreased with age at marriage and household size. The strongest associations were with age and household size, each accounting for about a 0.2 standard deviation difference in health agency score for each one standard deviation change (although in different directions). Similar differences were observed for those in paid employment compared to those who were not, and for those with higher education compared to those with no schooling. CONCLUSION Exclusion of women from maternal healthcare decision-making threatens the effectiveness of health interventions. Factors such as age, employment, education, and household size need to be considered when designing health interventions targeting new mothers living in challenging conditions, such as urban slums in low- and middle-income countries.
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Affiliation(s)
- Neha Batura
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH UK
| | - Stavros Poupakis
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH UK
| | - Sushmita Das
- Society for Nutrition, Education and Health Action, Mumbai, India
| | - Ujwala Bapat
- Society for Nutrition, Education and Health Action, Mumbai, India
| | - Glyn Alcock
- UCL Centre for the Health of Women, Children and Adolescents, London, UK
| | - Jolene Skordis
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH UK
| | | | | | - David Osrin
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH UK
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Jungari S, Chinchore S. Perception, Prevalence, and Determinants of Intimate Partner Violence During Pregnancy in Urban Slums of Pune, Maharashtra, India. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP239-NP263. [PMID: 32345120 DOI: 10.1177/0886260520914548] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There is limited evidence on the prevalence and determinants of violence against pregnant women in India. Previous studies were entirely restricted to the violence against women in the reproductive age group. There is lack of evidence about the factors affecting violence against women during pregnancy. Understanding such factors, women's perception regarding violence during pregnancy and their justification of such violence could manifest an important aspect of violence. Women living in slum communities particularly are victims of violence. In this context, this study intended to examine women's perception, prevalence of, and factors affecting the violence against women during pregnancy in the slum communities of Pune. A community-based cross-sectional study of 1-year duration was undertaken in urban slums of Pune city, Maharashtra, India. The study participants were women who have delivered 2 years preceding the survey. Using simple random sampling, 500 women were selected from 10 purposively selected slums. House-to-house visits were made and face-to-face interviews conducted using a pretested structured questionnaire. Univariate, bivariate, and logistic regression analyses were applied. The study results show that 15.3% of women have experienced violence during their recent pregnancy. Furthermore, 9.2% of women experienced physical violence, 1.8% sexual violence, and 11.2% psychological violence. Education level of women, husband's education and alcohol consumption, history of violence in the family, and provision of spurious justification for violence have emerged as some of the leading factors associated with the violence inflicted during pregnancy. Effective interventions at both community and health care settings are needed urgently to reduce the violence inflicted during pregnancy.
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Gothankar J, Pore P, Dhumale G, Doke P, Lalwani S, Quraishi S, Murarkar K S, Patil R, Waghachavare V, Dhobale R, Rasote K, Palkar S. Effect of Behavior Change Communication on the Incidence of Pneumonia in Under Five Children: A Cluster Randomized Controlled Trial. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2371-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abota TL, Gashe FE, Kabeta ND. Postpartum Women's Lived Experiences of Perinatal Intimate Partner Violence in Wolaita Zone, Southern Ethiopia: A Phenomenological Study Approach. Int J Womens Health 2021; 13:1103-1114. [PMID: 34803406 PMCID: PMC8598125 DOI: 10.2147/ijwh.s332545] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/28/2021] [Indexed: 01/10/2023] Open
Abstract
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.
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Affiliation(s)
- Tafesse Lamaro Abota
- Department of Nursing, College of Health Sciences, Mizan-Tepi University, Mizan-Aman, South West Ethiopia.,School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Negussie Deyessa Kabeta
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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15
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Yaya S, Odusina EK, Adjei NK, Uthman OA. Association between intimate partner violence during pregnancy and risk of preterm birth. BMC Public Health 2021; 21:1610. [PMID: 34479527 PMCID: PMC8414853 DOI: 10.1186/s12889-021-11625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background Preterm birth is a risk factor for child survival in both the short and long term. In Zimbabwe, the prevalence of preterm birth is rising, and there are growing concerns about the adverse consequences. This study explored the association between intimate partner violence (IPV) during pregnancy and preterm birth in Zimbabwe. Methods Using data from the 2015 Zimbabwe Demographic and Health Survey, we applied propensity score matching to estimate the effect of IPV during pregnancy on preterm birth among women of reproductive age (15–49 years). A total of 4833 pregnant women who gave birth during the five years preceding the survey were analysed. Results We successfully matched 79 women who were exposed to IPV during pregnancy to 372 unexposed during pregnancy. Using the matched sample, the probability of preterm delivery was significantly higher among women who were exposed to IPV during pregnancy than those who were not exposed. The findings showed that 7 out of 79 (8.9%) of women exposed to IPV during pregnancy experienced preterm delivery, and 11 out of 372 (3.0%) of those who were not exposed to IPV during pregnancy experienced preterm delivery. In the urban areas, those exposed to IPV during pregnancy were almost five times more likely to experience preterm delivery (OR = 4.8, 95% CI 2.0–11.6), but the association was not significantly different among women in rural areas. Conclusion The findings showed that women exposed to IPV during pregnancy were at increased risk of preterm birth. Some of the risk factors associated with IPV were urban residence, low economic status and unemployment. Effective policies and programmes are required to address the issue of IPV in Zimbabwe.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
| | | | - Nicholas Kofi Adjei
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Olalekan A Uthman
- Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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Jungari S. Violent Motherhood: Prevalence and Factors Affecting Violence Against Pregnant Women in India. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP6323-NP6342. [PMID: 30484355 DOI: 10.1177/0886260518815134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Violence against women is widely recognized as a serious public health problem in the world. Especially violence against pregnant women has more severe health consequences for both women and child. The objective of this study is to examine the prevalence and factors affecting violence during pregnancy in India. Data from the National Family Health Survey (NFHS)-4 are used to analyze this study. NFHS is a series of demographic health surveys conducted in India. Information on violence against pregnant women was collected for the first time in NFHS-4. Univariate and multivariate analyses are used to show the factors affecting violence during pregnancy. Study results reveal that the prevalence of violence varied among states from 0.5% to 9%, and women in South India were at a greater risk of abuse during pregnancy than that of women in other parts of India. Women with no education, women in poor household, women having three and more children, and women from rural area are at greater risk of being victims of violence during motherhood. Effective strategies such as responsive health care system, effective implementation of legal measures, and educating and engaging men in preventing violence are urgently needed.
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Nath A, Venkatesh S, Vindhya J, Balan S, Metgud CS. Prevalence of intimate partner violence among pregnant women attending a public sector hospital in Bengaluru, southern India. THE NATIONAL MEDICAL JOURNAL OF INDIA 2021; 34:132-137. [PMID: 34825535 DOI: 10.25259/nmji_309_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Intimate partner violence (IPV) is recognized as an important public health problem globally as well as in India. It may result in adverse physical and mental health consequences for the victim or unfavourable pregnancy outcomes if it happens during pregnancy. The possible risk factors for IPV can be explained by four levels of ecological factors: individual, partner, household and community. We estimated the prevalence of IPV and its association with selected ecological risk factors among pregnant women availing of antenatal care at a public sector hospital in Bengaluru, southern India. Methods We included 350 women above the age of 18 years with a confirmed pregnancy of less than 24 weeks and having no obstetric complication. We used the Conflict Tactics Scale to determine the presence of IPV. The risk factors measured were-individual level: respondent's age, education, occupation, gravidity, planned or unplanned pregnancy, substance abuse, presence of depression and anxiety; partner-related: spouse's education, occupation and marital discord; household/community-related: socioeconomic status, social support, religion and consanguinity. Results The prevalence of IPV was 3.7%. Factors that were significantly associated on multivariate analysis were higher age (above 20 years) (adjusted odds ratio [AOR] 1.82 [1.12-2.97], p=0.016) and presence of depression (AOR 6.84 [1.76-26.61], p=0.005). Conclusion The prevalence of IPV was less in our study population compared to figures reported from other Indian study settings.
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Affiliation(s)
- Anita Nath
- National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, Karnataka, India
| | - Shubhashree Venkatesh
- Indian Institute of Public Health Hyderabad-Bengaluru Campus, Public Health Foundation of India, Bengaluru, India
| | - J Vindhya
- Indian Institute of Public Health Hyderabad-Bengaluru Campus, Public Health Foundation of India, Bengaluru, India
| | - Sheeba Balan
- Indian Institute of Public Health Hyderabad-Bengaluru Campus, Public Health Foundation of India, Bengaluru, India
| | - Chandra S Metgud
- Department of Community Medicine, J.N. Medical College, K.L.E. University, Belgavi, Karnataka, India
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Kanougiya S, Daruwalla N, Gram L, Gupta AD, Sivakami M, Osrin D. Economic abuse and its associations with symptoms of common mental disorders among women in a cross-sectional survey in informal settlements in Mumbai, India. BMC Public Health 2021; 21:842. [PMID: 33933060 PMCID: PMC8088652 DOI: 10.1186/s12889-021-10904-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/21/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Domestic violence takes a range of interconnected forms, of which economic abuse is common, but less studied than others. We examine the prevalence of economic abuse, its determinants, and its association with symptoms of depression, anxiety, and suicidal ideation. METHODS Our cross-sectional survey in informal settlement areas in Mumbai, India, asked women aged 18-49 years 15 questions about acquisition, use, and maintenance of economic resources, demographic and socioeconomic factors, and physical, sexual, and emotional violence. We administered the Patient Health Questionnaire 9 (PHQ-9) and Generalised Anxiety Disorder 7 (GAD-7) scales and asked about suicidal thinking. Determinants of economic abuse and its associations with positive screens for depression and anxiety were explored in univariable and multivariable logistic regression models. RESULTS Of 4906 ever-married women respondents, 23% reported at least one form of economic abuse by either an intimate partner or another family member. The commonest were denial of property rights (10%), not being trusted with money (8%), and coercive appropriation of belongings (7%). Economic abuse was more commonly reported by widowed, separated, or divorced women than by married women (aOR 12.4; 95% CI 6.4, 24.1), and when their partners used alcohol or drugs (aOR 1.4; 95% CI 1.2-1.7). Women had greater odds of reporting economic abuse if they had suffered emotional (aOR 6.3; 95% CI 5.0-7.9), physical (aOR 1.9; 95% CI 1.4-2.6), or sexual violence (aOR 5.4; 95% CI 3.6-8.1) in the preceding 12 months. Economic abuse was independently associated with positive screens for moderate-severe depression (aOR 2.6; 95% CI 2.0-3.4), anxiety (aOR 2.7; 95% CI 1.9-3.8), and suicidal ideation (aOR 2.2; 95% CI 1.5-3.1). The odds of anxiety and depression increased with each additional form of economic abuse. DISCUSSION To our knowledge, this is the first community-based study in India of the prevalence of economic abuse and its associations with symptoms of common mental disorders. It provides empirical support for the idea that economic abuse is at least as harmful to women's mental health as physical violence. Surveys should include questions on economic abuse and prevention and intervention strategies need to help survivors to understand its forms.
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Affiliation(s)
- Suman Kanougiya
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra 400017 India
- School of Health Systems Studies (SHSS), Tata Institute of Social Sciences (TISS), Mumbai, Maharashtra, India
| | - Nayreen Daruwalla
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra 400017 India
| | - Lu Gram
- Institute for Global Health, University College London, London, WC1N IEH UK
| | - Apoorwa Deepak Gupta
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra 400017 India
| | - Muthusamy Sivakami
- School of Health Systems Studies (SHSS), Tata Institute of Social Sciences (TISS), Mumbai, Maharashtra, India
| | - David Osrin
- Institute for Global Health, University College London, London, WC1N IEH UK
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Islam MJ, Broidy L, Mazerolle P, Baird K, Mazumder N. Exploring Intimate Partner Violence Before, During, and After Pregnancy in Bangladesh. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:3584-3612. [PMID: 29792129 DOI: 10.1177/0886260518775753] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Intimate partner violence (IPV) against pregnant or postpartum women is known to have multiple detrimental effects on women and their children. Although results from past research suggest much continuity in trajectories of IPV, it is unclear whether pregnancy interrupts or augments these patterns. Little is known about how physical, sexual, and psychological IPV change and overlap throughout a woman's transition to parenthood. Relying on population-based data, this study examines the prevalence, co-occurring nature, and the changing patterns of physical, sexual, and psychological IPV before, during, and after pregnancy in Bangladesh. Cross-sectional survey data were collected between October 2015 and January 2016 in the Chandpur District of Bangladesh from 426 new mothers, aged 15 to 49 years, who were in the first 6 months postpartum. IPV was assessed with a validated set of survey items. The frequencies of different types of IPV victimization according to the period of occurrence were calculated separately and in a cumulative, co-occurring manner. The prevalence of physical IPV before, during, and after pregnancy was 52.8%, 35.2%, and 32.2%, respectively. The comparative figures for psychological IPV were 67.4%, 65%, and 60.8%, and for sexual IPV were 21.1%, 18.5%, and 15.5%, respectively. The results demonstrate a notable continuity in IPV victimization before, during, and after pregnancy. Psychological IPV is the only type to exhibit a significant reduction during and after pregnancy, compared with before pregnancy, but it commonly overlaps with physical IPV, which shows a significant change during pregnancy and little change in the postpartum period. At the same time, pregnancy and childbirth offer little protection against IPV for women in relationships characterized by psychological or sexual victimization, both of which commonly overlap with physical IPV. Results reinforce the need to conduct routine screening during pregnancy to identify women with a history of IPV and to offer necessary help and support.
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Affiliation(s)
- Md Jahirul Islam
- Griffith University, Brisbane, Queensland, Australia
- Bangladesh Planning Commission, Dhaka, Bangladesh
| | - Lisa Broidy
- Griffith University, Brisbane, Queensland, Australia
- The University of New Mexico, Albuquerque, USA
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Abdi F, Mahmoodi Z, Afsahi F, Shaterian N, Rahnemaei FA. Social determinants of domestic violence against suburban women in developing countries: a systematic review. Obstet Gynecol Sci 2021; 64:131-142. [PMID: 33503736 PMCID: PMC7991000 DOI: 10.5468/ogs.20211] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/01/2020] [Accepted: 11/30/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE In addition to the many social, economic, cultural, security, and environmental problems in the metropolitan areas, suburbanization has led to the growth and spread of domestic violence against women, and is still increasing. Different social determinants can play a role in violence against suburban women, so this study was designed to investigate the social determinants of domestic violence in suburban women of developing countries. METHODS According to PRISMA guideline, the keywords, which were determined considering MESH, were searched in Google Scholar, MEDLINE, SID, Web of Science, Pubmed, Scopus and Science Direct with the 2009 to 2019 time limit. STROBE checklist was used for evaluating quantitative studies and JBI for qualitative studies. Finally 30 high quality studies were included. RESULTS The prevalence of general domestic violence among women of different ages was reported between 2.3-73.78% in the suburban regions of developing countries. The prevalence of physical, emotional and psychological violence was about 11.54-61.6% and 7.8-84.3%. The prevalence of sexual,economic and the verbal violence was about 0.8-58.8%, 13.7- 43.7% and 33.21-86.1%. The most common factors affecting violence against women were the structural factors of early marriage, the husband's addiction to alcohol and drugs. CONCLUSION General domestic violence and its various types are prevalent in different parts of the world and the factors affecting domestic violence such as age, marriage age, low literacy, husband addiction to alcohol and drugs are all things that can be prevented by special health planning in these areas to improve women's health and thus prevent violence against suburban women.
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Affiliation(s)
- Fatemeh Abdi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj,
Iran
| | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj,
Iran
| | - Fatemeh Afsahi
- Master Student of Clinical Psychology, Department of Psychology, Tehran Medical Sciences, Islamic Azad University, Tehran,
Iran
| | - Negin Shaterian
- Student Research Committee, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Fatemeh Alsadat Rahnemaei
- Student Research Committee, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
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Mojahed A, Alaidarous N, Kopp M, Pogarell A, Thiel F, Garthus-Niegel S. Prevalence of Intimate Partner Violence Among Intimate Partners During the Perinatal Period: A Narrative Literature Review. Front Psychiatry 2021; 12:601236. [PMID: 33633606 PMCID: PMC7900188 DOI: 10.3389/fpsyt.2021.601236] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/12/2021] [Indexed: 01/19/2023] Open
Abstract
Intimate partner violence (IPV) affects individuals and families from all backgrounds, regardless of their ethnicity, socio-economic status, sexual orientation, or religion. Pregnancy and childbirth could be a time of vulnerability to violence because of changes in physical, emotional, social, and economic demands and needs. Prevalence of IPV against women during the perinatal period is increasingly researched and documented. However, evidence on IPV prevalence among intimate partners as well as on the course of IPV over the perinatal period is scarce. The purpose of this review was to provide a narrative synthesis of the existing literature regarding the prevalence estimates of IPV among intimate partners over the perinatal period. Through this review, we also gained better insight into associated factors, as well as the various forms of IPV. Of the 766 studies assessing prevalence estimates identified, 86 were included, where 80 studies focused on unidirectional IPV (i.e., perpetrated by men against women) and six studies investigated bidirectional IPV (i.e., IPV perpetrated by both partners). Most of the included studies reported lower overall prevalence rates for unidirectional IPV postpartum (range: 2-58%) compared to pregnancy (range: 1.5-66.9%). Psychological violence was found to be the most prevalent form of violence during the entire perinatal period. Studies on bidirectional IPV mostly reported women's perpetration to be almost as high as that of their partner or even higher, yet their findings need to be interpreted with caution. In addition, our results also highlighted the associated factors of IPV among partners, in which they were assimilated into a multi-level ecological model and were analyzed through an intersectional framework. Based on our findings, IPV is found to be highly prevalent during the entire perinatal period and in populations suffering from social inequalities. Further research exploring not only the occurrence, but also the motivations and the context of the bidirectionality of IPV during the perinatal period may facilitate better understanding of the detrimental consequences on partners and their families, as well as the development of effective intervention strategies. Public health prevention approaches intervening at optimal times during the perinatal period are also needed.
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Affiliation(s)
- Amera Mojahed
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty, Technical University of Dresden, Dresden, Germany
| | - Nada Alaidarous
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada
| | - Marie Kopp
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty, Technical University of Dresden, Dresden, Germany
| | - Anneke Pogarell
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Freya Thiel
- Department of Medicine, Faculty of Medicine, Medical School Hamburg, Hamburg, Germany
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty, Technical University of Dresden, Dresden, Germany
- Department of Medicine, Faculty of Medicine, Medical School Hamburg, Hamburg, Germany
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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Vijayalakshmi P, Gandhi S, Sai Nikhil Reddy S, Palaniappan M, Badamath S. Violence Against Women with Mental Illness and Social Norms and Beliefs: Nursing Professional Perspective. Community Ment Health J 2021; 57:212-218. [PMID: 32448934 DOI: 10.1007/s10597-020-00635-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
Violence against women is a priority public health issue globally and women with mental illness are at double disadvantage. While social norms and beliefs play a critical role in influencing violence among women, limited or no research is available from India. To explore nurses and nursing students' views on social norms and beliefs that support Violence against women with mental illness. A descriptive cross-sectional survey was carried out among randomly selected registered nurses and nursing students (N = 209) using self-reported questionnaires. Majority of the participants confronted norms (76.7%) and situations that justify (67.7%) abuse among women with mental illness. Nurses reported more negative attitudes than nursing students with regard to norms and beliefs (t = - 2.714, p < 0.007) and justifiability of abuse (t = - 3.089, p < 0.002). The findings suggest suitable academic programs to extinguish the prevailing cultural beliefs that support abuse in women with mental illness.
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Affiliation(s)
- Poreddi Vijayalakshmi
- College of Nursing, National Institute of Mental Health and Neuro Sciences (Institute of National Importance, Bangalore, India.
| | - Sailaxmi Gandhi
- Department of Nursing, National Institute of Mental Health and Neuro Sciences (Institute of National Importance, Bangalore, India
| | | | - Marimuthu Palaniappan
- Department of Bio-Statistics, National Institute of Mental Health and Neuro Sciences (Institute of National Importance, Bangalore, India
| | - Suresh Badamath
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (Institute of National Importance, Bangalore, India
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Román-Gálvez RM, Martín-Peláez S, Martínez-Galiano JM, Khan KS, Bueno-Cavanillas A. Prevalence of Intimate Partner Violence in Pregnancy: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E707. [PMID: 33467538 PMCID: PMC7830915 DOI: 10.3390/ijerph18020707] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Intimate partner violence (IPV) is a public health concern, especially during pregnancy, and needs to be urgently addressed. In order to establish effective actions for the prevention of IPV during pregnancy, authorities must be aware of the real burden of IPV. This review aimed to summarize the existing evidence about IPV prevalence during pregnancy worldwide. METHODS A review of reviews was carried out. All published systematic reviews and meta-analyses published until October 2020 were identified through PubMed, Scopus, and Web of Science. The main outcome was the IPV prevalence during pregnancy. RESULTS A total of 12 systematic reviews were included in the review, 5 of them including meta-analysis. The quality of the reviews was variable. Physical IPV during pregnancy showed a wide range (1.6-78%), as did psychological IPV (1.8-67.4%). CONCLUSIONS Available data about IPV prevalence during pregnancy were of low quality and showed high figures for physical and psychological IPV. The existing evidence syntheses do not capture the totality of the worldwide disease burden of IPV in pregnancy.
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Affiliation(s)
- Rosario M. Román-Gálvez
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Granada, 18071 Granada, Spain;
- Unidad Asistencial Churriana de la Vega, Servicio Andaluz de Salud, Churriana de la Vega, 18194 Granada, Spain
| | - Sandra Martín-Peláez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, 18071 Granada, Spain; (K.S.K.); (A.B.-C.)
- Instituto de Investigación Biosanitaria de Granada IBS, 18014 Granada, Spain
| | - Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaén, 23071 Jaén, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Khalid Saeed Khan
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, 18071 Granada, Spain; (K.S.K.); (A.B.-C.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Aurora Bueno-Cavanillas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, 18071 Granada, Spain; (K.S.K.); (A.B.-C.)
- Instituto de Investigación Biosanitaria de Granada IBS, 18014 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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Avanigadda DB, Kulasekaran RA. Associations between intimate partner violence and pregnancy complications: A cross-sectional study in India. J Family Community Med 2021; 28:17-27. [PMID: 33679185 PMCID: PMC7927968 DOI: 10.4103/jfcm.jfcm_256_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/30/2020] [Accepted: 11/02/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The high prevalence rates of violence of the intimate partner affects the maternal health of the woman that sometimes ends in maternal mortality as well as the possibility of an adverse effect on the newborn. The purpose of this study was to assess the prevalence and determinants of intimate physical and sexual intimate partner violence (IPV) on mothers and examine the association between IPV and pregnancy complications. MATERIALS AND METHODS Data for the present study were retrieved from the National Family Health Survey-IV (2015-2016). In total, 79,729 women completed the domestic violence questions, but 24,882 were considered for this analysis. The study was restricted to currently married women aged 15-49 who had given birth to at least one child in the 5 years preceding the survey. The association between self-reporting pregnancy complications with the experience of IPV was examined using Chi-square test, followed by multivariate logistic regression. RESULTS The study findings show that IPV, specifically physical and sexual violence, are associated with pregnancy complications. The results show that 31.6% of the women had experienced some form of IPV. The factors associated with IPV included husband's alcohol habit, women who had witnessed parental violence, and women whose husbands had shown high marital controlling behavior. The high level of pregnancy complications was reported by women who had experienced sexual violence, emotional violence, and women whose husbands display three or more specific behaviors. CONCLUSION Confidential screening for IPV and prompt referral to support services could be crucial in improving women's reproductive health.
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Affiliation(s)
- Durga B Avanigadda
- Department of Population Studies, Annamalai University, Annamalai Nagar, Tamil Nadu, India
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Bhatta N, Assanangkornchai S, Rajbhandari I. Does husband's alcohol consumption increase the risk of domestic violence during the pregnancy and postpartum periods in Nepalese women? BMC Public Health 2021; 21:5. [PMID: 33390166 PMCID: PMC7780634 DOI: 10.1186/s12889-020-10021-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 12/08/2020] [Indexed: 12/02/2022] Open
Abstract
Background Domestic violence against women during pregnancy and the postpartum period not only violates the human rights of women but also harms on the health of both mother and child. Domestic violence is entrenching in social norms, customs and structural factors against women in Nepal. The use of alcohol also exacerbates domestic violence. The objective of this study was to determine the association between domestic violence against women and husband’s drinking behavior across the periods of pregnancy and postpartum. Methods This study was a cross-sectional study conducted in the antenatal care and postnatal care clinics of a government hospital in Kathmandu district. Among 660 women (aged 15–49), 165 women were consecutively recruited from each trimester of pregnancy and the postpartum period. Adjusted odds ratios (AOR) were computed from a multivariate logistic regression model to determine the association between domestic violence against women and the husband’s drinking behavior. Results Women whose husbands drank alcohol were twice as likely to suffer from domestic violence, compared to those women whose husbands did not drink (AOR = 2.12; 95% CI: 1.4–3.2), independently of their socio-demographic status. Women suffered from domestic violence in each period of pregnancy and postpartum due to their husband’s drinking habits, but the most affected period was the second trimester of pregnancy. Among women who suffered from physical, psychological and sexual violence during the pregnancy and postpartum periods, 70.2, 67.9, and 64.2% respectively experienced violence due to their husband’s drinking habit. Other associated factors for domestic violence included the ethnic culture of Janjati ethnicity, illiteracy of the women, duration of marriage 2–5 years (compared to one year or less) and a husband who behaved in a controlling manner. Conclusions Having a husband who has alcohol drinking behavior is an important risk factor for domestic violence against women in the pregnancy and postpartum periods. Screening of alcohol use in husbands will not prevent domestic violence but could lead to a referral to integrated treatment for alcohol and domestic violence treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10021-y.
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Affiliation(s)
- Narayan Bhatta
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Thailand.
| | | | - Ishwari Rajbhandari
- Department of Neurosurgery, National Neurological Referral Center, Bir Hospital, Kathmandu, 44600, Nepal
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Jamieson B. Exposure to Interpersonal Violence During Pregnancy and Its Association With Women's Prenatal Care Utilization: A Meta-Analytic Review. TRAUMA, VIOLENCE & ABUSE 2020; 21:904-921. [PMID: 30322355 DOI: 10.1177/1524838018806511] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Inadequate prenatal care utilization has been proposed as a mechanism between exposure to violence during pregnancy and adverse maternal and fetal obstetric outcomes. Adequate prenatal care is important for identifying and treating obstetric complications as they arise and connecting pregnant women to supports and interventions as needed. There is some evidence that pregnant women experiencing relational violence may delay or never enter prenatal care, though this association has not been systematically or quantitatively synthesized. The present meta-analysis investigates the relationship between interpersonal violence during pregnancy and inadequate prenatal care utilization across two dimensions: (1) no prenatal care during gestation (k = 9) and (2) delayed entry into prenatal care (k = 25). Studies were identified via comprehensive search of 9 social science and health-related databases and relevant reference lists. Studies were included if (1) participants were human, (2) violence occurred in the context of an interpersonal relationship, (3) abuse occurred during pregnancy (including abuse within 12 months before the time of assessment during pregnancy), (4) the study was empirical, peer-reviewed, and included quantitative data, (5) prenatal care utilization data were available, (6) they were in English, and (7) they were not part of an intervention study. Results from random-effects models found that women abused during pregnancy were more likely to never enter care (odds ratio [OR] = 2.62, 95% confidence interval [CI] = [1.55, 4.42]) or to delay care (OR = 1.81, 95% CI [1.48, 2.23]). Sociodemographic, abuse-related, and methodological factors emerged as moderators. Practice, policy, and research implications are discussed.
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Affiliation(s)
- Brittany Jamieson
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
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Jungari S, Chauhan BG, Bomble P, Pardhi A. Violence against women in urban slums of India: A review of two decades of research. Glob Public Health 2020; 17:115-133. [PMID: 33253046 DOI: 10.1080/17441692.2020.1850835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
It is estimated that about one-third of women ever experienced violence in their lifetime. India has experienced steady urban growth accompanying increase of urban populations living in slums. Several studies have reported prevalence of various forms of violence in urban slums. To our knowledge, no systematic review has been conducted exclusively reporting violence against women in India's urban slums. The review aims to synthesise the studies of violence against women conducted in the last two decades (2000-2020). We searched PubMed, Scopus and other relevant search engines to identify articles published between years 2000 and 2020, which focused on Indian women slum dwellers' experiences of violence. We included 14 studies, which satisfied the inclusion criteria in this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was used to assess the studies. The prevalence of any form of violence against women, as reported in the studies, ranged from 15% to 59.3%. The major risk factors identified were husband's alcohol abuse, women justifying the violence inflicted on then, low educational levels of both women and men, dowry issues, age difference between the spouses and termination of a previous pregnancy. It is evident from the review that urban slum women experience persistent violence.
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Affiliation(s)
- Suresh Jungari
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Bal Govind Chauhan
- Population Research Centre, Gokhle Institute of Politics and Economics, Pune, India
| | - Priyanka Bomble
- Department of Public Health & Mortality Studies, International Institute of Population Sciences, Mumbai, India
| | - Ashish Pardhi
- School of Social Work, Tata Institute of Social Sciences, Mumbai, India
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Ahinkorah BO, Ameyaw EK, Seidu AA, Agbaglo E, Budu E, Mensah F, Adu C, Yaya S. Sexual violence and unmet need for contraception among married and cohabiting women in sub-Saharan Africa: Evidence from demographic and health surveys. PLoS One 2020; 15:e0240556. [PMID: 33141830 PMCID: PMC7608905 DOI: 10.1371/journal.pone.0240556] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Contraception plays a significant role in fertility regulation and determines the reproductive health rights of women. Studies in other parts of the world have found that sexual violence has negative effects on unmet need for contraception. There has not been any study on the association between these two phenomena in sub-Saharan Africa using current nationally-representative survey data. We investigated the association between sexual violence and unmet need for contraception among married and cohabiting women in sub-Saharan Africa. MATERIALS AND METHODS This study was based on secondary datasets from 26 sub-Saharan African countries' Demographic and Health Surveys conducted between 2010 and 2018. A sample of 101,968 women in sexual unions (married and cohabiting) with complete information on sexual violence and all the variables of interest were included in the analyses. Both bivariate and multilevel logistic regression analyses were carried out to examine the association between sexual violence and unmet need for contraception. Other individual and contextual level socio-economic and demographic variables were considered as covariates. Crude odds ratios [cOR] and adjusted odds ratios [aOR] with their corresponding 95% confidence intervals [CI], signifying precision, were presented. Level of statistical significance was declared at p<0.05. RESULTS The overall prevalence of sexual violence and unmet need for contraception in the 26 sub-Saharan African countries were 8.7% and 28.7% respectively. Experience of sexual violence within the last 12 months resulted in 10% increase in unmet need for contraception [OR = 1.10, CI = 1.03-1.14] and 5% increase in unmet need for contraception after controlling for individual and contextual level factors [aOR = 1.05, CI = 1.01-1.11]. With the individual level factors, women with 4 or more births [aOR = 4.85, CI = 4.41-5.33], those cohabiting [aOR = 1.43, CI = 1.37-1.47], those in female headed households [aOR = 1.22, CI = 1.18-1.27] and those who watched television at least once a week [aOR = 1.12, CI = 1.07-1.16] had higher odds of unmet need for family planning. However, those aged 30-34 [aOR = 0.56, CI = 0.52-0.61], those with secondary/higher level of education [AOR = 0.80, CI = 0.77-0.84], those who read newspaper less than once a week [aOR = 0.75, CI = 0.71-0.79] and those who listened to radio at least once a week [aOR = 0.94, CI = 0.90-0.97] had lower odds of unmet need for contraception. In terms of the contextual factors, women in rural areas [aOR = 0.87, CI = 0.84-0.91] and those in the richest wealth quintile households [aOR = 0.80, CI = 0.75-0.85] had lower odds of unmet need for contraception. CONCLUSION Our study has shown an association between sexual violence and unmet need for contraception in sub-Saharan Africa. Experiencing sexual violence increases the likelihood of unmet need for contraception in sub-Saharan Africa. It is also worthy to note that having four or more children, cohabiting with a male partner, and living in female-headed households are some of the key variables associated with unmet need for contraception in sub-Saharan Africa. Our study recommends that, successful contraceptive initiatives should focus on reducing sexual violence, while taking into consideration other significant factors that increase unmet need for contraception. Meanwhile, in doing this, contextual factors ought to be prioritised.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Ebenezer Agbaglo
- Department of English, University of Cape Coast, Cape Coast, Ghana
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- * E-mail:
| | - Felix Mensah
- Fr. Thomas Alan Rooney Memorial Hospital, Asankrangwa, Western Region, Ghana
| | - Collins Adu
- Department of Health Promotion, and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sanni Yaya
- The George Institute for Global Health, The University of Oxford, Oxford, United Kingdom
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
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Chen GL, Silverman JG, Dixit A, Begum S, Ghule M, Battala M, Johns NE, Raj A, Averbach S. A cross-sectional analysis of intimate partner violence and family planning use in rural India. EClinicalMedicine 2020; 21:100318. [PMID: 32322807 PMCID: PMC7170943 DOI: 10.1016/j.eclinm.2020.100318] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) has been shown to be associated differentially with contraceptive use based on type, with IPV more likely among pill users and less likely among condom users. Recent increases in IUD uptake allow consideration of this type of contraceptive. We assessed the association between self-reported IPV and self-reported contraceptive use, by type, among non-pregnant married women in rural India in a region with higher than average IUD use. METHODS We assessed the association between past 12-month IPV (physical, sexual, or any) and past 3-month contraceptive use (condom, pill, IUD, or any modern method) using crude and adjusted multinomial logistic regression models. FINDINGS Among the 1001 women included, 109 (10·9%) reported experiencing physical IPV and 27 (2·7%) reported experiencing sexual IPV in the past 12 months. Women experiencing physical IPV were significantly less likely to use condoms (adjusted relative risk ratio [RRR]: 0·54, 95% confidence interval [CI]: 0·30-0·98, p = 0·042) than women not experiencing violence. There was a trend towards increased IUD use among women experiencing physical IPV (adjusted RRR: 1·78, 95% CI: 0·91-3·41, p = 0·091) compared to those not experiencing physical IPV, but this did not reach statistical significance. INTERPRETATION Our findings suggest that women who experience physical IPV in India are less likely to use condoms and may be more likely to use IUDs than women without exposure to IPV. This research expands on prior findings suggesting higher uptake of women-controlled contraceptives among women contending with IPV in India.
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Affiliation(s)
- Grace L. Chen
- University of California San Diego School of Medicine, 9500 Gilman Drive #0606, La Jolla, CA 92093, United States
| | - Jay G. Silverman
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
| | - Anvita Dixit
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
- Joint Doctoral Program in Public Health, San Diego State University, University of California San Diego, San Diego, CA, United States
| | - Shahina Begum
- Department of Biostatistics, ICMR-National Institute for Research in Reproductive Health, J.M Street, Parel, Mumbai 400012, India
| | - Mohan Ghule
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
| | - Madhusudana Battala
- Population Council, Zone 5A, Ground Floor, India Habitat Center, Lodi Road, New Delhi 110003, India
| | - Nicole E. Johns
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
| | - Anita Raj
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
| | - Sarah Averbach
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego School of Medicine, 9300 Campus Point Drive #7433, La Jolla, CA 92037, USA
- Corresponding author at: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego School of Medicine, 9300 Campus Point Drive #7433, La Jolla, CA 92037, USA.
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30
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Is unintended birth associated with physical intimate partner violence? Evidence from India. J Biosoc Sci 2020; 52:907-922. [PMID: 31902374 DOI: 10.1017/s0021932019000865] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A growing number of studies have tested the association between intimate partner violence (IPV) and the unintendedness of pregnancy or birth, and most have suggested that unintendedness of pregnancy is a cause of IPV. However, about nine in every ten women face violence after delivering their first baby. This study examined the effects of the intendedness of births on physical IPV using data from the National Family Health Survey (2015-16). The multivariate logistic regression model analysis found that, compared with women with no unwanted births (2.9%), physical IPV was higher among those women who had unwanted births (6.9%, p<0.001), followed by those who had mistimed births (4.4 %, p<0.001), even after adjusting for several women's individual and socioeconomic characteristics. Thus, the reduction of women with mistimed and unwanted births could reduce physical IPV in India. The study highlights the unfinished agenda of family planning in the country and argues for the need to integrate family planning and Reproductive, Maternal and Child Health Care (RMNCH) services to yield multi-sectoral outcomes, including the elimination of IPV.
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Richardson R, Nandi A, Jaswal S, Harper S. The effect of intimate partner violence on women's mental distress: a prospective cohort study of 3010 rural Indian women. Soc Psychiatry Psychiatr Epidemiol 2020; 55:71-79. [PMID: 31177309 PMCID: PMC7140984 DOI: 10.1007/s00127-019-01735-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 06/03/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE Intimate partner violence (IPV) encompasses physical, sexual, and psychological abuse, as well as controlling behavior. Most research focuses on physical and sexual abuse, and other aspects of IPV are rarely investigated. We estimated the effect of these neglected aspects of IPV on women's mental distress. METHODS We used data from 3010 women living in rural tribal communities in Rajasthan, India. Women completed baseline interviews and were re-interviewed approximately 1.5 years later. We measured IPV with questions adopted from the Demographic and Health Survey's Domestic Violence Module, which asked seven questions about physical abuse, three questions about psychological abuse, and five questions about partner controlling behavior. Mental distress was measured with the 12-item General Health Questionnaire (score range 0-12). We used Poisson regression models to estimate the relation between changes in IPV and mental distress, accounting for time-fixed characteristics of individuals using individual fixed effects. RESULTS Women reported an average of 2.1 distress symptoms during baseline interviews. In models that controlled for time-varying confounding (e.g., wealth, other types of abuse), experiencing psychological abuse was associated with an increase of 0.65 distress symptoms (95% CI 0.32, 0.98), and experiencing controlling behavior was associated with an increase of 0.31 distress symptoms (95% CI 0.18, 0.44). However, experiencing physical abuse was not associated with an increase in distress symptoms (mean difference = - 0.15, 95% CI - 0.45, 0.15). CONCLUSIONS Psychological abuse and controlling behavior may be important drivers of the relation between IPV and women's mental health.
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Affiliation(s)
- Robin Richardson
- Department of Epidemiology, Columbia University, 722 West 168 th, New York, NY, 10032, USA.
| | - Arijit Nandi
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada,Institute for Health and Social Policy, McGill University, Montreal, Canada
| | - Surinder Jaswal
- Centre for Health and Mental Health, Tata Institute of Social Sciences, Mumbai, India
| | - Sam Harper
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada,Institute for Health and Social Policy, McGill University, Montreal, Canada
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Dasgupta A, Saggurti N, Ghule M, Reed E, Donta B, Battala M, Nair S, Ritter J, Gajanan V, Silverman J, Raj A. Associations between intimate partner violence and married women's condom and other contraceptive use in rural India. Sex Health 2019; 15:381-388. [PMID: 30045806 DOI: 10.1071/sh17090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 03/26/2018] [Indexed: 11/23/2022]
Abstract
Background The existing literature on the intersection between women's reports of spousal intimate partner violence (IPV) and contraceptive use in South Asia is conflicted. Results vary based on method of contraception use and form of violence (physical or sexual), and few examine the relationship between IPV and various methods of modern spacing contraceptive (MSC) use. This study examines associations between IPV and MSC use among a sample of married, not-currently pregnant couples in rural Maharashtra, India (n=861). METHODS Multinomial logistic regression models assessed wives' physical and sexual IPV victimisation (for the past 6-months) in relation to the wives' past 3-month MSC use (categorised as condom use, other MSCs [oral pills, Intrauterine device (IUD)] and no MSCs). RESULTS In terms of violence, 9% (n=78) and 4% (n=34) of wives reported recent physical and sexual IPV victimisation, respectively. The majority (72%; n=621) did not use any MSC method in the past 3 months; 14% (n=119) reported recent condom use, and the same proportion reported other MSC use. Recent physical IPV was associated with increased likelihood of recent condom use (AOR: 2.46, 95% CI: 1.20, 5.04), and recent sexual IPV was associated with increased likelihood of recent use of other MSC (AOR: 3.27, 95% CI: 1.24, 8.56). CONCLUSIONS These findings reinforce the need for integration of counselling around IPV prevention and intervention programming into existing family planning services targeting married couples in rural Maharashtra, India.
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Affiliation(s)
- Anindita Dasgupta
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, USA
| | - Niranjan Saggurti
- Population Council, Zone 5A, Ground Floor, India Habitat Centre, Lodi Road, New Delhi 110003, India
| | - Mohan Ghule
- Equal Community Foundation, B-14 Sasoon Road, Opp Ruby Hall Clinic, Pune-411 011, India
| | - Elizabeth Reed
- Division of Health Promotion and Behavior, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - Balaiah Donta
- National Institute for Research in Reproductive Health, Jehangir, Merwanji Street, Parel, Mumbai-400 023, India
| | - Madhusudana Battala
- Population Council, Zone 5A, Ground Floor, India Habitat Centre, Lodi Road, New Delhi 110003, India
| | - Saritha Nair
- National Institute of Medical Statistics, Ansari Nagar, New Delhi, Delhi 110029, India
| | - Julie Ritter
- Division of Global Public Health, Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92093-0507, USA
| | - Velhal Gajanan
- Topiwala National Medical College & Bai Yamunabai Laxman Nair Charitable Hospital, Dr A. L. Nair Road, Mumbai, Maharashtra 400008, India
| | - Jay Silverman
- Division of Global Public Health, Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92093-0507, USA
| | - Anita Raj
- Division of Global Public Health, Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92093-0507, USA
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Semahegn A, Torpey K, Manu A, Assefa N, Tesfaye G, Ankomah A. Are interventions focused on gender-norms effective in preventing domestic violence against women in low and lower-middle income countries? A systematic review and meta-analysis. Reprod Health 2019; 16:93. [PMID: 31262331 PMCID: PMC6604322 DOI: 10.1186/s12978-019-0726-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 04/24/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND One in three women experience intimate partner violence worldwide, according to many primary studies. However, systematic review and meta-analysis of intimate partner violence is very limited. Therefore, we set to summarize the findings of existing primary studies to generate evidence for informed decisions to tackle domestic violence against women in low and lower-middle income countries. METHODS Studies were searched from main databases (Medline via PubMed, EMBASE, CINAHL, PopLine and Web of Science), Google scholar and other relevant sources using electronic and manual techniques. Published and unpublished studies written in English and conducted among women aged (15-49 years) from 1994 to 2017 were eligible. Data were extracted independently by two authors, and recorded in Microsoft Excel sheet. Heterogeneity between included studies was assessed using I2, and publication bias was explored using visual inspection of funnel plot. Statistical analysis was carried out to determine the pooled prevalence using Comprehensive Meta-Analysis software. In addition, sub-group analysis was carried out by study-setting and types of intimate partner violence. RESULTS Fifty two studies were included in the systematic review. Of these, 33 studies were included in the meta-analysis. The pooled prevalence of lifetime intimate partner violence was 55% (95% CI: 52, 59%). Of these, main categories were lifetime physical violence [39% (95% CI: 33, 45%); psychological violence [45% (95% CI: 40, 52%)] and sexual violence [20% (95% CI: 17, 23%)]. Furthermore, the pooled prevalence of current intimate partner violence was 38% (95% CI: 34, 43%). Of these, physical violence [25% (95% CI: 21, 28%)]; psychological violence [30% (95% CI: 24, 36%)] and sexual violence [7.0% (95% CI: 6.6, 7.5%)] were the pooled prevalence for the major types of intimate partner violence. In addition, concurrent intimate partner violence was 13% (95% CI: 12, 15%). Individual, relationship, community and societal level factors were associated with intimate partner violence. Traditional community gender-norm transformation, stakeholders' engagement, women's empowerment, intervention integration and policy/legal framework were highly recommended interventions to prevent intimate partner violence. CONCLUSION Lifetime and current intimate partner violence is common and unacceptably high. Therefore, concerned bodies will need to design and implement strategies to transform traditional gender norms, engage stakeholders, empower women and integrate service to prevent violence against women. PROTOCOL REGISTRATION PROSPERO: 2017: CRD42017079977 .
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Affiliation(s)
- Agumasie Semahegn
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Science, University of Ghana, Legon, Accra, Ghana
- College of Health and Medical Sciences, Haramaya University, Po. Box 235, Harar, Ethiopia
| | - Kwasi Torpey
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Science, University of Ghana, Legon, Accra, Ghana
| | - Abubakar Manu
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Science, University of Ghana, Legon, Accra, Ghana
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Po. Box 235, Harar, Ethiopia
| | - Gezahegn Tesfaye
- College of Health and Medical Sciences, Haramaya University, Po. Box 235, Harar, Ethiopia
| | - Augustine Ankomah
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Science, University of Ghana, Legon, Accra, Ghana
- Population Council/Ghana, Yiyiwa Drive, Accra, Ghana
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Joshi D, Shrestha S, Shrestha N. Understanding the antepartum depressive symptoms and its risk factors among the pregnant women visiting public health facilities of Nepal. PLoS One 2019; 14:e0214992. [PMID: 30947251 PMCID: PMC6448918 DOI: 10.1371/journal.pone.0214992] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 03/25/2019] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Antepartum depression is a contributing factor for adverse maternal and perinatal outcome. The study aimed to assess the antepartum depressive symptoms in selected public health facilities of Nepal. METHODOLOGY This is a mixed-method cross-sectional study that included 143 pregnant women attending the antenatal checkup in four public health facilities of Kathmandu. Edinburgh Postnatal Depression Scale (EPDS) tool with cut-off score > = 10 was used to assess the antepartum depressive symptoms. Bivariate and multivariable analysis was carried out to identify factors associated with the depressive symptoms. Further semi-structured interviews were conducted with 12 pregnant women identified with the depressive symptoms. RESULT Of the total 143 pregnant women, 26 (18%, CI at 95% 12.6-25.5) reported depressive symptoms. Multivariable analysis reported higher odds of antepartum depressive-symptoms with health problem, early gestational age, sex preference, and spousal alcohol intake. Thematic analysis of qualitative data further revealed participants' apprehension on; birth outcome, a family expectation of male child, inadequate support from the family/husband and disturbed family environment. CONCLUSION Notable proportion of pregnant women were reported with antepartum depressive symptoms. Women's perception on patriarchal values for childbirth was revealed to be important factor for the depressive symptoms. The study draws an attention to a need for screening for antepartum depression into primary health care system. Strengthening ongoing efforts on gender equity could contribute the psychological well-being of pregnant women.
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Affiliation(s)
- Deepak Joshi
- Health and Nutrition Department, Save the Children, Kathmandu, Nepal
- * E-mail:
| | | | - Nipun Shrestha
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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Abdulkader RS, Sathiyamoorthy K, Jeyashree K. Will I, Wont I? Factors associated with self-reported prediction of future indulgence in intimate partner violence among adolescents in South India. Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2018-0207/ijamh-2018-0207.xml. [PMID: 30707684 DOI: 10.1515/ijamh-2018-0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 10/07/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Intimate partner violence (IPV) refers to acts of physical/sexual violence, emotional/psychological abuse and controlling behaviour by a current or former intimate partner. Understanding the attitudes and perspectives of adolescents towards IPV can help in its prevention. The study aimed to assess the knowledge about various domains of IPV and self-reported prediction of perpetrating IPV among adolescents in Madurai city, South India. METHODS Students pursuing engineering, medicine and humanities were recruited conveniently. A structured self-administered questionnaire developed to cater to the objectives was used. After descriptive analysis, a modified Poisson regression with robust variance estimation was used to identify factors associated with one's self-reported prediction of becoming an IPV perpetrator and adjusted relative risks [0.95 confidence interval (CI)] were calculated. The project was approved by the Institute's Ethics Committee. RESULTS Of the 369 students, 40% were aware of IPV prevalence among women in India. About 85% agreed with societally prescribed gender roles. More males than females found gender roles manifesting as IPV acceptable (p = 0.003). Only 6.8%, more females than males (p = 0.01), believed that no violence is permissible in intimate relationships. About 55% definitely did not foresee themselves becoming IPV perpetrators. Belief in gender roles [odds ratio (OR) = 3.85; 95% CI: 1.26, 11.74] and being a professional course student (2.48; 1.25, 4.91) were significantly associated with foreseeing oneself as an IPV perpetrator. CONCLUSION Knowledge about IPV and its redressal mechanisms among adolescents is poor. A significant proportion of them believe in gender roles and perceive violence within an intimate relationship as acceptable. Positively influencing adolescents' beliefs in gender roles may help to control IPV and nurture healthier relationships.
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Affiliation(s)
| | | | - Kathiresan Jeyashree
- Department of Community Medicine, Velammal Medical College Hospital and Research Institute, Madurai, India, Phone: +91-9043114998
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Ram A, Victor CP, Christy H, Hembrom S, Cherian AG, Mohan VR. Domestic Violence and its Determinants among 15-49-Year-Old Women in a Rural Block in South India. Indian J Community Med 2019; 44:362-367. [PMID: 31802801 PMCID: PMC6881899 DOI: 10.4103/ijcm.ijcm_84_19] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Context: Domestic violence in Indian setting has five major components: emotional abuse; physical violence; sexual violence; honor killing; dowry-related abuse; and death. Aims: The aim of the study was to estimate the prevalence of domestic violence and 3 of its components – emotional abuse, physical violence, and sexual violence among women in the age group of 15–49 years in Kaniyambadi block, rural Vellore, Tamil Nadu and to determine the risk factors of domestic violence. Settings and Design: A community-based cross-sectional study among women between the ages 15 and 49 years at the rural setting of Kaniyambadi block, Tamil Nadu. Results: Prevalence of all forms of domestic violence among women was 77.5%, and forty percent women were classified as having ever been subjected to severe domestic violence. Prevalence of physical violence was 65.8%, sexual abuse was 17.5%, and emotional abuse was 54.2%. Alcohol consumption by husband (adjusted odds ratio [AOR] 4.37; 1.35, 14.18), controlling behavior by family member (AOR 8.07; 2.47, 26.37), and woman's employment (AOR 4.33; 1.27, 14.77) were statistically significant determinants of domestic violence. Three-fourth (73.1%) of the women felt that being subjected to domestic violence has affected their physical and mental health. Conclusions: The high prevalence of domestic violence in our community needs to be addressed as it has tacit implications on socioeconomic well-being, physical and mental health of a woman, her family, and thereby, society as a whole.
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Affiliation(s)
- Ananth Ram
- Department of Community Medicine, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | | | - Hana Christy
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sneha Hembrom
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anne George Cherian
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Venkata Raghava Mohan
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
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Wagman JA, Donta B, Ritter J, Naik DD, Nair S, Saggurti N, Raj A, Silverman JG. Husband's Alcohol Use, Intimate Partner Violence, and Family Maltreatment of Low-Income Postpartum Women in Mumbai, India. JOURNAL OF INTERPERSONAL VIOLENCE 2018; 33:2241-2267. [PMID: 26802047 PMCID: PMC6886467 DOI: 10.1177/0886260515624235] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Husbands' alcohol use has been associated with family-level stress and intimate partner violence (IPV) against women in India. Joint family systems are common in India and IPV often co-occurs with non-violent family maltreatment of wives (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care). Alcohol use increases for some parents following the birth of a child. This study examined 1,038 postpartum women's reports of their husbands' alcohol use and their own experiences of IPV (by husband) and non-violent maltreatment from husbands and/or in-laws. We analyzed cross-sectional, quantitative data collected in 2008, from women (ages 15-35) seeking immunizations for their infants <6 months at three large urban health centers in Mumbai, India. Crude and adjusted logistic regression models estimated associations between the independent variable (husbands' past month use of alcohol) and two dependent variables (postpartum IPV and maltreatment). Overall, 15% of husbands used alcohol, ranging from daily drinkers (10%) to those who drank one to two times per week (54%). Prevalence of postpartum IPV and family maltreatment was 18% and 42%, respectively. Prevalence of IPV among women married to alcohol users was 27%. Most abused women's husbands always (27%) or sometimes (37%) drank during violent episodes. Risk for IPV increased with a man's increasing frequency of consumption. Women who lived with a husband who drank alcohol, relative to non-drinkers, were more likely to report postpartum IPV, aOR = 2.0, 95% confidence interval (CI) = [1.3, 3.1]. Husbands' drinking was marginally associated with increased risk for family maltreatment, aOR = 1.4, 95% CI = [1.0, 2.1]. Our findings suggest that men's alcohol use is an important risk factor for postpartum IPV and maltreatment. Targeted services for Indian women contending with these issues are implicated. Postpartum care offers an ideal opportunity to screen for IPV, household maltreatment, and other health risks, such as husband's use of alcohol. There is need to scale up proven successful interventions for reducing men's alcohol use and design strategies that provide at-risk women protection from alcohol-related IPV.
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Affiliation(s)
| | - Balaiah Donta
- National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India
| | | | - D. D. Naik
- National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India
| | - Saritha Nair
- National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | | | - Anita Raj
- University of California, San Diego, CA, USA
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Taghizadeh Z, Pourbakhtiar M, Ghasemzadeh S, Azimi K, Mehran A. The effect of training problem-solving skills for pregnant women experiencing intimate partner violence: a randomized control trial. Pan Afr Med J 2018; 30:79. [PMID: 30344863 PMCID: PMC6191243 DOI: 10.11604/pamj.2018.30.79.14872] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/11/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction Intimate partner violence (IPV) in pregnancy is considered as an additional threat to the maternal/fetal health. The present study was aimed to investigate the effectiveness of training problem-solving skills on IPV against pregnant women. Methods The present randomized clinical trial was conducted on 125 and 132 women visiting the health centers of Tehran as the intervention and the control groups, respectively; samples were selected using random stratified cluster sampling. The intervention group underwent four problem-solving training sessions. Three months later, both groups completed the revised Conflict Tactics Scale questionnaire. Data were analyzed using SPSS v.16. Results The mean (SD) ages of the participants were 27.51 (4.26) and 27.02 (4.26) years, respectively, in the control and the intervention groups. The rates of the physical and psychological violence were significantly reduced after the intervention in the intervention group. Risk differences of the physical, psychological and sexual violence before and after the intervention were 3% (95% CI: -8.23 to14.13, P = 0.6), 1.5% (95% CI: -4.93 to 8.03, P = 0.6) and 4.8% (95% CI: -7.11 to 16.52, P = 0.4) in the control group and 8.8% (95% CI: -3.47 to 20.71, P = 0.1), 25.4% (95% CI: 15.77 to 34.66, P < 0.001) and 4.9% (95% CI: -7.38 to16.97, P = 0.4) in the intervention group, respectively. Conclusion It seems that training this skill as a part of the routine prenatal care could be effective in reducing intimate partner violence.
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Affiliation(s)
- Ziba Taghizadeh
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Pourbakhtiar
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Iran
| | - Sogand Ghasemzadeh
- Department of Psychology and Education of Exceptional Children, University of Tehran, Tehran, Iran
| | - Khadijeh Azimi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Iran
| | - Abbas Mehran
- Master of Biostatistics, Faculty of Tehran University of Medical Sciences, Tehran, Iran
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Xing J, Ying Y, Mao C, Liu Y, Wang T, Zhao Q, Zhang X, Yan F, Zhang H. Hypoxia induces senescence of bone marrow mesenchymal stem cells via altered gut microbiota. Nat Commun 2018; 9:2020. [PMID: 29789585 PMCID: PMC5964076 DOI: 10.1038/s41467-018-04453-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 04/27/2018] [Indexed: 12/16/2022] Open
Abstract
Systemic chronic hypoxia is a feature of many diseases and may influence the communication between bone marrow (BM) and gut microbiota. Here we analyse patients with cyanotic congenital heart disease (CCHD) who are experiencing chronic hypoxia and characterize the association between bone marrow mesenchymal stem cells (BMSCs) and gut microbiome under systemic hypoxia. We observe premature senescence of BMSCs and abnormal d-galactose accumulation in patients with CCHD. The hypoxia that these patients experience results in an altered diversity of gut microbial communities, with a remarkable decrease in the number of Lactobacilli and a noticeable reduction in the amount of enzyme-degraded d-galactose. Replenishing chronic hypoxic rats with Lactobacillus reduced the accumulation of d-galactose and restored the deficient BMSCs. Together, our findings show that chronic hypoxia predisposes BMSCs to premature senescence, which may be due to gut dysbiosis and thus induced d-galactose accumulation. Systemic chronic hypoxia is a feature of many diseases and may influence the communication between bone marrow and gut microbiota. Here, the authors show that chronic hypoxia predisposes bone marrow stem cells to premature senescence, which may be due to gut dysbiosis and gut microbiota-derived d-galactose accumulation.
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Affiliation(s)
- Junyue Xing
- State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.,Key Laboratory of Cardiac Regenerative Medicine, National Healthy Commission, Fuwai Hospital, Beijing, 100037, China.,Center for Pediatric Cardiac Surgery, Fuwai Hospital, CAMS&PUMC, Beijing, 100037, China
| | - Yongquan Ying
- Department of Thoracic and Cardiovascular Surgery, Taizhou Hospital, Zhejiang, 317000, China
| | - Chenxi Mao
- Department of Thoracic and Cardiovascular Surgery, 1st Affiliated Hospital of Wenzhou Medical University, Zhejiang, 325006, China
| | - Yiwei Liu
- State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.,Key Laboratory of Cardiac Regenerative Medicine, National Healthy Commission, Fuwai Hospital, Beijing, 100037, China
| | - Tingting Wang
- State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.,Key Laboratory of Cardiac Regenerative Medicine, National Healthy Commission, Fuwai Hospital, Beijing, 100037, China
| | - Qian Zhao
- State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Xiaoling Zhang
- State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.,Key Laboratory of Cardiac Regenerative Medicine, National Healthy Commission, Fuwai Hospital, Beijing, 100037, China
| | - Fuxia Yan
- Center for Pediatric Cardiac Surgery, Fuwai Hospital, CAMS&PUMC, Beijing, 100037, China
| | - Hao Zhang
- State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China. .,Key Laboratory of Cardiac Regenerative Medicine, National Healthy Commission, Fuwai Hospital, Beijing, 100037, China. .,Center for Pediatric Cardiac Surgery, Fuwai Hospital, CAMS&PUMC, Beijing, 100037, China.
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Intimate partner violence during pregnancy and use of antenatal care among rural women in southern Terai of Nepal. Women Birth 2018; 31:96-102. [PMID: 28844866 DOI: 10.1016/j.wombi.2017.07.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 07/23/2017] [Accepted: 07/25/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Underutilisation of antenatal care services due to intimate partner violence during pregnancy has been well documented elsewhere, but it is understudied in Nepal. Our study aimed at exploring the impact of intimate partner violence on antenatal care service utilisation in southern Terai of Nepal. METHOD A community-based cross-sectional study was performed in 6 village development committees in Dhanusha district, Nepal. A total of 426 pregnant women in their second trimester were selected using a multistage cluster sampling method. Multivariable regression analyses were used to examine the association between exposure to intimate partner violence and selected antenatal care services, adjusting for covariates. RESULTS Among 426 pregnant women, almost three out of ten women (28.9%) were exposed to intimate partner violence at some point during their pregnancy. Pregnant women who were exposed to intimate partner violence were less likely to: register for antenatal care (OR 0.31; 95% CI (0.08-0.50)), take iron and folic acid (OR 0.55; 95% CI (0.12-0.90)), report dietary diversity (middle vs low: OR 0.34; 95% CI (0.11-0.58) and high vs low: OR 0.18; 95% CI (0.08-0.37)), have rest and sleep during day time (OR 0.47; 95% CI (0.61-0.58)), and attend mother's group meetings (OR 0.29; 95% CI (0.10-0.83)). CONCLUSIONS Intimate partner violence during pregnancy is associated with low utilisation of antenatal care services. Therefore, effective strategies to prevent or reduce intimate partner violence during pregnancy is needed, which may lead to improved antenatal care service utilization in Nepal with healthier mothers and children's outcome.
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Semahegn A, Torpey K, Manu A, Assefa N, Ankomah A. Community based intervention to prevent domestic violence against women in the reproductive age in Northwestern Ethiopia: a protocol for quasi-experimental study. Reprod Health 2017; 14:155. [PMID: 29162117 PMCID: PMC5698924 DOI: 10.1186/s12978-017-0414-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/10/2017] [Indexed: 11/24/2022] Open
Abstract
Background Violence against women is a well understood devastating global pandemic, and human right violation. One in three women experienced intimate partner violence worldwide. In Ethiopia, the level of domestic violence against women is one of the highest in the world. However, Ethiopia is signatory for various conventions and incorporated in legal frameworks. Nevertheless, effective implementation of the existing policy documents, and engaging different stakeholders is very limited. Therefore, we aimed to pilot feasibility of implementing available research evidence and policy documents at community level to prevent domestic violence against women in Awi zone, northwestern Ethiopia. Methods A community-based quasi-experimental study design will be employed using mixed method. Multistage stratified systematic sampling and purposive sampling will be used to recruit quantitative and qualitative study participants, respectively. A total of 1,269 women will be participated in the intervention, active comparator and control groups. Pre and post-test quantitative data will be collected using face-to-face interview. Qualitative data will be collected through in-depth, key informant interview and focus group discussions. Intervention: advocacy meeting will be held to persuade local politicians and sustain the implementation of community based intervention to prevent domestic violence against women. Community representatives will be trained to enhance peer education to promote community awareness and engage stakeholders to transform the traditional gender norm within local context. Awareness creation and husband involvement will be made through integrating the intervention with community health extension program. Only husband involvement will not be promoted in the active comparator to test the role of husband involvement on the domestic violence prevention activities. Intervention progress will be monitored regularly. Gathered data will be entered in Epidata and exported to SPSS (23.0) software for analysis. Descriptive statistics, logistic regressions, intention to treat analysis and difference in differences will be computed. Qualitative data will be transcribed, color coded, thematically analyzed and arranged using Nvivo. Discussion This interventional study is aimed to design, pilot and translate proven research evidence, agreed conventions and country policy document to real setting implementation. We are expecting to initiate implementation of culturally acceptable intervention through engaging stakeholders. Policy makers, planners and any concerned bodies will be benefited. Trial registration ClinicalTrials.gov ID: NCT03265626
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Affiliation(s)
- Agumasie Semahegn
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Science, University of Ghana, Legon, Accra, Ghana. .,College of Health and Medical Sciences, Haramaya University, Po. Box 235, Harar, Ethiopia.
| | - Kwasi Torpey
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Science, University of Ghana, Legon, Accra, Ghana
| | - Abubakar Manu
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Science, University of Ghana, Legon, Accra, Ghana
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Po. Box 235, Harar, Ethiopia
| | - Augustine Ankomah
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Science, University of Ghana, Legon, Accra, Ghana
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Debono C, Borg Xuereb R, Scerri J, Camilleri L. Intimate partner violence: psychological and verbal abuse during pregnancy. J Clin Nurs 2017; 26:2426-2438. [PMID: 27571315 DOI: 10.1111/jocn.13564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2016] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To examine the association between sociodemographic, pregnancy-related variables and psychological and verbal intimate partner abuse, as well as to determine which of these variables are predictors of psychological and verbal intimate partner abuse during pregnancy. BACKGROUND Intimate partner violence is a significant health issue, with severe implications to both mother and foetus. However, much of the research to date focuses on the outcomes of physical abuse. This article addresses the dearth in the literature by examining the association between sociodemographic, pregnancy-related variables and psychological and verbal intimate partner abuse during pregnancy. DESIGN A survey research design was used. METHOD Three hundred postnatal women were recruited by convenience, nonproportional quota sampling technique. The WHO Violence Against Women Instrument was self-administered by participants. The association between categorical variables was assessed using Pearson's chi-square test, the strength of association using Cramer's V and the phi coefficient, and the identification of predictor variables for psychological and verbal abuse using logistic regression analysis. RESULTS Four predictors were identified for psychological abuse, namely low education level in women, an unplanned pregnancy, experiencing two or more pregnancy-related health problems and living with an unemployed partner. However, unemployment in women, an unplanned pregnancy, fear of partner and a low education level of partner were identified as the predictors of verbal abuse. CONCLUSION This study identified a number of variables that strongly predict psychological and verbal intimate partner abuse during pregnancy; however, it extends the available literature by identifying a low standard of education in males, unemployment and fear of the intimate partner as the significant predictors of psychological and verbal intimate partner abuse. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals should be aware of the predictors predisposing pregnant women to abuse. This would enable the identification of pregnant women who are susceptible to psychological and verbal intimate partner abuse, thus enabling the provision of adequate support. There is also a need to introduce routine screening for psychological and verbal intimate partner abuse during the antenatal period, following extensive training to all professionals concerned.
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Affiliation(s)
- Christie Debono
- Department of Midwifery, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Rita Borg Xuereb
- Department of Midwifery, Faculty of Health Sciences, University of Malta, Msida, Malta.,International Confederation of Midwives, The Hague, the Netherlands
| | - Josianne Scerri
- Department of Mental Health, Faculty of Health Sciences, University of Malta, Msida, Malta.,Kingston University and St George's, University of London, London, UK
| | - Liberato Camilleri
- Statistics & Operations Research, Faculty of Science, University of Malta, Msida, Malta
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Jain S, Varshney K, Vaid NB, Guleria K, Vaid K, Sharma N. A hospital-based study of intimate partner violence during pregnancy. Int J Gynaecol Obstet 2017; 137:8-13. [PMID: 28099692 DOI: 10.1002/ijgo.12086] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/05/2016] [Accepted: 12/19/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine the prevalence and types of intimate partner violence (IPV) during pregnancy, factors linked with IPV, and effects of IPV on maternal-fetal outcomes. METHODS In a prospective observational study at a tertiary care hospital in Delhi, India, 400 women at 20-28 weeks of pregnancy were screened for IPV between December 2013 and April 2015. The women completed a detailed questionnaire and were followed up until delivery. RESULTS Overall, 49 (12.3%) women experienced IPV during pregnancy. The most prevalent type of IPV was emotional (43/400 [10.7%]), followed by physical (40/400 [10.0%]) and sexual (7/400 [1.8%]). The most prevalent factor triggering IPV was intimate partner's desire for a son (17/49 [34.7%]). Women and their intimate partners were older in the IPV group than in the control group, and duration of marriage was longer (P<0.05 for all). Multigravidity, lower socioeconomic status, low education level of intimate partner, and partners' addiction were more common in the IPV group (P<0.05 for all). Obstetric outcomes were similar in both groups. Depression was diagnosed in 19 (46.3%) women affected by IPV. CONCLUSION IPV was documented in approximately 12% of participants. Population-based surveys need to be done to investigate further.
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Affiliation(s)
- Sandhya Jain
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Khushboo Varshney
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Neelam B Vaid
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Kiran Guleria
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Keya Vaid
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Neha Sharma
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Monterrosa-Castro Á, Arteta-Acosta C, Ulloque-Caamaño L. Violencia doméstica en adolescentes embarazadas: caracterización de la pareja y prevalencia de las formas de expresión. IATREIA 2017. [DOI: 10.17533/udea.iatreia.v30n1a03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Chen L, Yu Z, Luo X, Huang Z. Intimate partner violence against married rural-to-urban migrant workers in eastern China: prevalence, patterns, and associated factors. BMC Public Health 2016; 16:1232. [PMID: 27927195 PMCID: PMC5142315 DOI: 10.1186/s12889-016-3896-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 11/30/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a significant public health issue among married rural-to-urban migrant workers, the largest group of internal migrants in China. This study aims to explore the prevalence, patterns and associated factors of intimate partner violence against married rural-to-urban migrant workers in eastern China. METHODS A cross-sectional study was conducted in Zhejiang province in China between July 2015 and April 2016, and a total of 1,744 married rural-to-urban migrant workers ultimately took part in the study. Conflict Tactics Scales and several short demographic questions were applied. Data were principally analyzed with logistic regression. RESULTS The majority of married rural-to-urban migrant workers were middle-aged couples with a low education level and a relatively long-term duration of migration in fixed migrant cities. Nearly 45% of married rural-to-urban migrant workers were experienced at least one incident of intimate partner violence during the past 12 months. The joint occurrence of multiple forms of violence is the most commonly reported features of intimate partner violence, especially three overlapping patterns of intimate partner violence. Some individual (education and age), relationship (marital satisfaction, premarital sex and extramarital affairs) and social (duration of migration and number of migratory cities) factors of the respondents, were negatively or positively associated with intimate partner violence against married rural-to-urban migrant workers. CONCLUSION The results indicated that one out of two married rural-to-urban migrant workers experienced at least one incident of intimate partner violence during the past 12 months in China. Accordingly, there is an obvious demand of intervention and treatment activities to prevent and reduce the occurrence of intimate partner violence among the millions of migrant workers in China.
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Affiliation(s)
- Li Chen
- Department of Psychology, School of Psychiatry, Wenzhou Medical University, Wenzhou, China
| | - Zonghuo Yu
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Xianming Luo
- Department of Psychology, School of Psychiatry, Wenzhou Medical University, Wenzhou, China
| | - Zhaoxin Huang
- Department of Humanities and Social Sciences, Wenzhou Medical University, Wenzhou, China
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Shrestha M, Shrestha S, Shrestha B. Domestic violence among antenatal attendees in a Kathmandu hospital and its associated factors: a cross-sectional study. BMC Pregnancy Childbirth 2016; 16:360. [PMID: 27871256 PMCID: PMC5117509 DOI: 10.1186/s12884-016-1166-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Domestic violence during pregnancy is a public health problem which violates human rights and causes an adverse effect on both maternal and fetal health. The objectives of the study were to assess the prevalence of domestic violence among the pregnant women attending the antenatal clinic, to explore the associated factors, and to identify the perpetrators of domestic violence. METHODS A descriptive cross-sectional study was conducted among 404 pregnant women in their third trimester of pregnancy. Convenient sampling was used to select the study population. Data collection tools consisted of questionnaires on socio-demographic characteristics of the woman and her spouse, social support, and the woman's attitude towards domestic violence, along with her experiences of psychological, physical, and sexual violence. Domestic violence was assessed using a questionnaire adapted from a World Health Organization multi-country study on women's health and life experiences. Relationships between domestic violence and the various factors were determined by bivariate analysis using a chi-square test. Binary logistic regression with 95% confidence interval and adjusted odds ratio were then applied to assess the factors independently associated with domestic violence. RESULTS More than one-quarter (27.2%) of the pregnant women had experienced some form of violence. The most common form of violence was sexual violence (17.3%), followed by psychological violence (16.6%) and physical violence (3.2%). Husbands within the age group 25-34 years (AOR = 0.38), women married for 2-5 years (AOR = 0.42) and who had one or two children (AOR = 0.32) were negatively associated with domestic violence. Whereas the presence of husband's controlling behavior (AOR = 1.88) and experience of violence before the current pregnancy (AOR = 24.55) increased the odds of experiencing violence during pregnancy. The husband was the major perpetrator in all type of violence. CONCLUSIONS Domestic violence is common among pregnant women attending an antenatal clinic. It indicates a need for routine screening during antenatal visits to identify women experiencing violence and thus provide support services, thereby preventing them from adverse health consequences.
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Affiliation(s)
- Monika Shrestha
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Sumina Shrestha
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Binjwala Shrestha
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Silverman JG, Balaiah D, Ritter J, Dasgupta A, Boyce SC, Decker MR, Naik DD, Nair S, Saggurti N, Raj A. Maternal morbidity associated with violence and maltreatment from husbands and in-laws: findings from Indian slum communities. Reprod Health 2016; 13:109. [PMID: 27608805 PMCID: PMC5017035 DOI: 10.1186/s12978-016-0223-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) victimization is linked to a broad range of negative maternal health outcomes. However, it is unclear whether IPV is directly related to poor maternal outcomes or whether IPV is a marker for other forms of chronic, mundane maltreatment of women that stem from the culture of gender inequity that also gives rise to IPV. To determine the prevalence of non-violent forms of gender-based household maltreatment by husbands and in-laws (GBHM), and violence from in-laws (ILV) and husbands (IPV) against women during the peripregnancy period (during and in the year prior to pregnancy); to assess relative associations of GBHM, ILV and IPV with maternal health. METHODS Cross-sectional data were collected from women <6 months postpartum (n = 1,039, ages 15-35 years) seeking child immunization in Mumbai, India. Associations of IPV, ILV and GBHM during the peripregnancy period with maternal health (prenatal care in first trimester, no weight gain, pain during intercourse, high blood pressure, vaginal bleeding, premature rupture of membranes, premature birth) were evaluated. RESULTS One in three women (34.0 %) reported IPV, 4.8 % reported ILV, and 48.5 % reported GBHM during the peripregnancy period. After adjusting for other forms of abuse, IPV related to pain during intercourse (AOR = 1.79); ILV related to not receiving first trimester antenatal care (AOR = 0.49), and GBHM remained associated with premature rupture of membranes (AOR = 2.28), pain during intercourse (AOR = 1.60), and vaginal bleeding (AOR = 1.80). CONCLUSION After adjusting for ILV and IPV, peripregnancy GBHM remained significantly associated with multiple forms of maternal morbidity, suggesting that GBHM is a prevalent and reliable indicator of maternal health risk.
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Affiliation(s)
- Jay G Silverman
- Division of Global Public Health, Department of Medicine, Center on Gender Equity and Health, University of California, San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.
| | - Donta Balaiah
- National Institute for Research on Reproductive Health, Indian Council on Medical Research, Mumbai, India
| | - Julie Ritter
- Division of Global Public Health, Department of Medicine, Center on Gender Equity and Health, University of California, San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA
| | - Anindita Dasgupta
- Division of Global Public Health, Department of Medicine, Center on Gender Equity and Health, University of California, San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA
| | - Sabrina C Boyce
- Division of Global Public Health, Department of Medicine, Center on Gender Equity and Health, University of California, San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - D D Naik
- National Institute for Research on Reproductive Health, Indian Council on Medical Research, Mumbai, India
| | - Saritha Nair
- National Institute for Research on Reproductive Health, Indian Council on Medical Research, Mumbai, India
| | | | - Anita Raj
- Division of Global Public Health, Department of Medicine, Center on Gender Equity and Health, University of California, San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA
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Osei-Ampofo M, Flynn-O’Brien KT, Owusu-Dabo E, Otupiri E, Oduro G, Donkor P, Mock C, Ebel BE. Injury patterns and health outcomes among pregnant women seeking emergency medical care in Kumasi, Ghana: Challenges and opportunities to improve care. Afr J Emerg Med 2016; 6:87-93. [PMID: 30456072 PMCID: PMC6233248 DOI: 10.1016/j.afjem.2016.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/08/2015] [Accepted: 01/04/2016] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION In high-income countries, injury is the most common cause of non-obstetric death among pregnant women. However, the injury risk during pregnancy has not been well characterized for many developing countries including Ghana. Our study described maternal and fetal outcomes after injury at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, and identified associations between the prevalence of poor outcomes and maternal risk factors. METHODS We conducted a cross-sectional study to identify pregnant women treated for injury over a 12-month period at KATH in Kumasi, Ghana. Descriptive statistics were used to characterize the population. We identified the association between poor outcomes and maternal risk factors using multivariable Poisson regression. RESULTS There were 134 women with documented pregnancy who sought emergency care for injury (1.1% of all injured women). The leading injury mechanisms were motor vehicle collision (23%), poisoning (21%), and fall (19%). Assault was implicated in 3% of the injuries. Eleven women (8%) died from their injuries. The prevalence of poor fetal outcomes: fetal death, distress or premature birth, was high (61.9%). One in four infants was delivered prematurely following maternal injury. After adjusting for maternal and injury characteristics, poor fetal outcomes were associated with pedestrian injury (adjusted prevalence ratio (aPR) 2.5, 95% CI 1.5-4.6), and injury to the thoraco-abdominal region (aPR 2.1, 95% CI 1.4-3.3). CONCLUSIONS Injury is an important cause of maternal morbidity and poor fetal outcomes. Poisoning, often in an attempt to terminate pregnancy, was a common occurrence among pregnant women treated for injury in Kumasi. Future work should address modifiable risk factors related to traffic safety, prevention of intimate partner violence, and prevention of unintended pregnancies.
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Affiliation(s)
- Maxwell Osei-Ampofo
- Emergency Medicine Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Katherine T. Flynn-O’Brien
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, United States
- Department of Surgery, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Ellis Owusu-Dabo
- Kumasi Centre for Collaborative Research, Kumasi, Ghana
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Easmon Otupiri
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - George Oduro
- Emergency Medicine Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Peter Donkor
- Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Dept. of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Mock
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, United States
- Department of Surgery, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Beth E. Ebel
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, United States
- Department of Pediatrics, University of Washington, Seattle, WA, United States
- Seattle Children’s Hospital, Seattle, WA, United States
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Affiliation(s)
| | - Jacquelyn C Campbell
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore MD-21205, USA
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Nambiar D, Muralidharan A, Garg S, Daruwalla N, Ganesan P. Analysing implementer narratives on addressing health inequity through convergent action on the social determinants of health in India. Int J Equity Health 2015; 14:133. [PMID: 26578314 PMCID: PMC4650492 DOI: 10.1186/s12939-015-0267-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 11/08/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Understanding health inequity in India is a challenge, given the complexity that characterise the lives of its residents. Interpreting constructive action to address health inequity in the country is rare, though much exhorted by the global research community. We critically analysed operational understandings of inequity embedded in convergent actions to address health-related inequalities by stakeholders in varying contexts within the country. METHODS Two implementer groups were purposively chosen to reflect on their experiences addressing inequalities in health (and its determinants) in the public sector working in rural areas and in the private non-profit sector working in urban areas. A representing co-author from each group developed narratives around how they operationally defined, monitored, and addressed health inequality in their work. These narratives were content analysed by two other co-authors to draw out common and disparate themes characterising each action context, operational definitions, shifts and changes in strategies and definitions, and outcomes (both intended and unintended). Findings were reviewed by all authors to develop case studies. RESULTS We theorised that action to address health inequality converges around a unifying theme or pivot, and developed a heuristic that describes the features of this convergence. In one case, the convergence was a single decision-making platform for deliberation around myriad village development issues, while in the other, convergence brought together communities, legal, police, and health system action around one salient health issue. One case emphasized demand generation, the other was focussed on improving quality and supply of services. In both cases, the operationalization of equity broke beyond a biomedical or clinical focus. Dearth of data meant that implementers exercised various strategies to gather it, and to develop interventions - always around a core issue or population. CONCLUSIONS This exercise demonstrated the possibility of constructive engagement between implementers and researchers to understand and theorize action on health equity and the social determinants of health. This heuristic developed may be of use not just for further research, but also for on-going appraisal and design of policy and praxis, both sensitive to and reflective of Indian concerns and understandings.
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Affiliation(s)
- Devaki Nambiar
- Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Gurgaon, National Capital Region, 122002, India.
| | - Arundati Muralidharan
- Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Gurgaon, National Capital Region, 122002, India
| | - Samir Garg
- Chhattisgarh State Health Resource Centre, Raipur, Chhattisgarh, India
| | - Nayreen Daruwalla
- The Prevention of Violence Against Women and Children Programme, Society for Nutrition, Education, and Health Action (SNEHA), Mumbai, India
| | - Prathibha Ganesan
- Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Gurgaon, National Capital Region, 122002, India
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