Magnitude and factors associated with intimate partner violence in mainland Tanzania

Intimate partner violence influences modern family planning use among married women in Tanzania: cross-sectional study

BACKGROUND

Married women who experience intimate partner violence (IPV) are less likely to negotiate with their partners on modern family planning (FP) use. This study aimed to determine the influence of intimate partner violence and sociodemographics on modern family planning use.

METHODS

A community-based cross-sectional study was conducted in the Mara region, Tanzania from April to July 2020. A total of 366 married women were interviewed. Data were collected using a structured interviewer-administered questionnaire. Analysis was done using SPSS version 25, and a binary logistic regression model was used to determine the predictors of modern FP use. The significance level was set at a p-value less than 0.05.

RESULTS

The overall prevalence of IPV was 73% with 54.1% physical, 36.3% psychological, and 25.4%, sexual violence. The prevalence of modern FP use was 62%, and the most (49.1%) common method practiced by married women was injection (Depo Provera). Physical violence (AOR = 0.32, p = 0.0056), and psychological violence (AOR = 0.22, p = 0.0022) had significantly reduced odds of modern FP use. Religion (AOR = 4.6, p = 0.0085), and availability of preferred modern FP methods (AOR = 9.27, p < 0.0001) had significantly increased odds of modern FP use.

CONCLUSION

In this study, there is a positive association between the use of modern FP methods and IPV. To prevent IPV and its negative health consequences, it is crucial to involve community leaders and primary healthcare workers. They can help in identifying the best strategies to prevent IPV and promote the use of modern FP methods. It is equally important to involve male partners in reproductive health decisions, including the use of modern FP methods. This approach will help reduce reproductive coercion.

Magnitude of Spousal Violence and Associated Factors among Midlife Women in Ethiopia

Background

Intimate partner violence is the most common form of gender-based violence and has enormous maternal health consequences. There is limited evidence concerning the magnitude and determinants of intimate partner violence amongst midlife women. Thus, this study aimed to determine the extent of and the factors contributing to spousal violence amongst midlife Ethiopian women.

Methods

The 2016 Ethiopia Demographic and Health Survey (EDHS) data were examined, and a sample of 1628 ever-married midlife women was included. The analysis was performed using SPSS version 20. Bivariate and multivariable logistic regression analysis was conducted to examine the determinants of intimate partner violence. All statistical significance was declared at p value < 0.05.

Results

The prevalence of spousal violence among midlife women in Ethiopia was 31.8%. Age of women, divorced, and working status were significantly associated with spousal violence. The likelihood of spousal violence is increase among midlife women who had no formal education, less decision-making power in household, and had partner who had drinking habit.

Conclusion

This study showed that nearly one-thirds of midlife Ethiopian women have experienced spousal violence in their lifetime. Empowering midlife women by giving them decision-making tools and educating them to deal with, and prevent spousal violence may be effective strategies in reducing this problem.

Prevalence and correlates of intimate partner violence among ever-married men in Uganda: a cross-sectional survey

Background

There is limited research on intimate partner violence (IPV) among ever-married men in Uganda. This paper aimed to establish the extent and correlates of emotional, sexual, and physical IPV among ever-married men in Uganda.

Methods

We used the 2016 Uganda Demographic and Health Survey (UDHS) data and selected a weighted sample of 2559 ever-married men. Frequency distributions were used to describe the characteristics of men and their partners. Chi-square tests and binary logistic regressions were used to identify factors associated with IPV among married men in Uganda.

Results

Almost half (44%) of the ever-married men experienced some form of IPV. Among the individual forms of IPV, emotional IPV was the most prevalent (36%), followed by physical IPV (20%) and sexual IPV the least common (8%). Factors that were associated with all the different forms of IPV included, region, number of wives, partners’ controlling behaviors, witnessing parental violence, and drinking alcohol as well as the frequency of getting drunk by the female partners. Except for number of wives, which had a protective effect, the rest of the factors increased the likelihood of experiencing intimate partner violence among ever-married men in Uganda.

Conclusions

Besides women, men are also victims of intimate partner violence. This calls for combined efforts to reduce violence against men perpetrated by females by addressing controlling behaviors, frequency of getting drunk with alcohol, and lack of awareness of the issue. There is a need for interventions aimed at increasing public awareness to improve the reporting and case management of violence against men and boys.

Intimate partner violence and HIV testing during antenatal care: A latent class analysis to identify risk factors for HIV infection in mothers and their children in the United Republic of Tanzania

Intimate partner violence has adverse effects on mother's overall health and prevention of mother to child HIV transmission. To identify and examine subgroups of mothers experiencing intimate partner violence and the likelihood of HIV testing during antenatal care, we conducted a latent class analysis using data from the Tanzania Demographic and Health Survey 2010 (N = 2,809). Intimate partner violence included mother's experiences with partners' controlling behaviors, as well as emotional, physical, and sexual violence. The outcome was mother's accepting HIV testing offered during their antenatal care visit. Covariates included mother's level of education, rural/urban residence, and prevention of mother to child HIV transmission talk during antenatal care visit. The latent class analysis indicated a three-class solution was the best model and identified the following profiles: mothers with no experience of intimate partner violence (61% of sample) with a 90.5% likelihood of HIV testing; mothers with moderate levels of intimate partner violence (26%) with an 84.7% likelihood of testing; and mothers with extreme levels of intimate partner violence (13%) with an 82% likelihood of testing. An auxiliary multinomial logistic regression with selected covariates was conducted to further differentiate IPV profiles, where mothers with extreme levels of intimate partner violence had 57% increased odds [95%CI:1.06-2.33, p = .023] of living in rural areas compared to mothers with no experience of intimate partner violence. Our person-centered methodological approach provided a novel model to understand the impact of multiple intimate partner violence risk factors on antenatal care HIV testing to identify mothers in need of interventions and their children at highest for parent to child HIV transmission. Our model allows person-centered interventional designs tailored for the most at-risk subgroups within a population.

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

BACKGROUND

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

METHODS

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

RESULT

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

CONCLUSION

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

Prevalence and Risk Factors of Women's Past-Year Physical IPV Perpetration and Victimization in Tanzania

Recent studies of intimate partner violence (IPV) in high-resource countries suggest that men and women may perpetrate similar rates of violence against their partners, yet the prevalence and etiology of female-perpetrated IPV, especially in comparison with IPV victimization among females, remains largely understudied in low-resource, high-prevalence countries, particularly in sub-Saharan Africa. Using multivariate logistic regression models, the current study examines the prevalence of and risk factors associated with past 12-month experiences of isolated physical IPV perpetration (i.e., violence perpetrated against an intimate partner not in self-defense) and physical IPV victimization among a nationally representative sample of women of reproductive age (15-49 years) from Tanzania who completed the Tanzanian Demographic and Health Survey Domestic Violence Module (n = 5,372). Approximately 1.5% reported perpetrating violence in the past 12 months, whereas 35% reported victimization in the same time period. Risk factors of past 12-month IPV perpetration included past 12-month IPV victimization, making cash or in-kind earnings, having autonomy in decision making, and acceptance of justifications for wife beating. Women much younger than their partners had lower odds of IPV perpetration. Risk factors of past 12-month IPV victimization included past 12-month IPV perpetration, educational attainment, having children, partner's alcohol consumption, partner's decision making, acceptance of justifications for wife beating, and exposure to parental IPV. Making cash or in-kind earnings was the only protective factor against victimization. Findings suggest that female IPV perpetration and victimization may result from a combination of factors including power differentials between partners and attitudes about the acceptability of using violence. Future research directions and implications for policy and prevention efforts to reduce IPV in Tanzania are discussed.

Does resilience moderate the effect of intimate partner violence on signs of depression among Tanzanian pregnant women: A cross-sectional study

INTRODUCTION

Exposure to intimate partner violence (IPV) has been found to be associated with a multitude of poor health and quality of life outcomes. Among the risks exacerbated by IPV is prenatal depression. Resilience is hypothesized to protect against psychopathology after exposure to a traumatic influence. The present study aims to investigate resilience as a moderator of the effect of exposure to IPV on prenatal depression among pregnant women in Moshi, Tanzania.

MATERIAL AND METHODS

In this cross-sectional study, nested within a larger longitudinal study, pregnant women receiving antenatal care were interviewed about exposure to IPV, signs of depression using the Edinburgh Postpartum Depression Scale, and resilience using the abbreviated Connor-Davidson Resilience Scale. Logistic regression was used to test the effect of the interaction term of resilience and exposure to IPV during pregnancy on the risk of high level of signs of depression.

RESULTS

In total, 1013 women completed all interviews, 300 women reported exposure to IPV, and 113 had high levels of signs of depression. Mean resilience score was 14.26 (SD 9.45). Exposure to IPV was correlated with signs of depression (adjusted odds ratio 6.49, 95% CI 3.75-11.24). Resilience was not correlated with signs of depression, nor was the interaction term of resilience and exposure to IPV.

CONCLUSIONS

The study did not find that resilience acted as a moderator of the effect of exposure to IPV during pregnancy on the risk of prenatal depression. The cross-sectional design of the study may not be well suited to investigate resilience, which could take time to manifest. The abbreviated Connor-Davidson Resilience Scale has not been validated in a Tanzanian setting, or in the Swahili version. Practitioners should take note that all women and families affected by IPV should be afforded relevant assistance from social services, law enforcement, healthcare practitioners, and other relevant services, regardless of their apparent level of resilience.

Qualitative reappraisal of perspectives, prevalence, and management of family violence among the Yoruba people: a study of representatives of some Yoruba ethnic subgroups from Ile Ife

Objective

The analysis of changing definitions and perspectives of violating behaviors within cultural contexts will inform the responses and interventions that will mostly reduce the occurrences of family violence.

Methods

This study used focus group discussions of purposively selected participants to generate data that were analyzed using content with themes of definition, perspectives, prevalent forms, persons mostly affected, perpetrators, and management strategies among the Yoruba people.

Results

There were multiple words and descriptions in the local Yoruba language for abuse and violence, but no single word for either of the two concepts. Common forms of family violence identified were verbal assaults from parents to children, among couples, siblings, physical assault of children by parents, physical assault of parents by children, neglect of children, parents, spouses mostly wives, sexual harassment, and sexual violence. Neglect of wives and children was perceived to be increasing, occurring in one in four houses. Sexual harassment and sexual violence were perceived to be rare, but the latter not an issue in marriage. A variant of sexual “touching” said to be tolerated with unmarried young people was identified as common among this ethnic group. Age and gender were dominant factors in the use of common forms of violence. Informal approaches were methods of management of family violence but perceived inadequate.

Conclusions

This study concluded that family violence is a common phenomenon occurring among family members. Hence, formal acceptable interventions that will be appropriate for this ethnic subgroup are required.

"It is painful and unpleasant": experiences of sexual violence among married adolescent girls in Shinyanga, Tanzania

BACKGROUND

While the situation of married adolescent girls in Tanzania is increasingly documented, empirical evidence concerning the ways in which child marriage impacts girls' and young women's sexual lives is limited. Specifically, little is known about lived experiences on sexual violence among married adolescent girls in Tanzania.

METHODS

This article reports on a qualitative study using a phenomenological approach to describe married girls' experiences of sexual violence in the Shinyanga Region, an area with the highest prevalence (59%) of child marriage in Tanzania. Data were collected from 20 married girls aged 12-17 years.

RESULTS

The study identified four analytical themes regarding the experience of sexual violence, namely: forced sex; rape; struggling against unpleasant and painful sex; and inculcation of the culture of tolerance of sexual violence.

CONCLUSION

The study highlights the voices of married adolescents on an important but a neglected topic of relevance to Tanzania's public health. Findings from this study suggest that married adolescent girls suffer sexual coercion in silence. Child marriage is a major public health problem in sub-Saharan Africa in general and in Tanzania in particular. However, there is limited research on the ways in which it impacts sexual lives of married adolescent girls. In response to the inadequacy of information, married adolescent girls in Shinyanga Region of Tanzania were requested to voice out their experiences of sexual violence. Three themes were identified from the responses, namely: forced sex; rape, struggling against unpleasant and painful sex; and the inculcation of the culture of tolerance of sexual violence. In conclusion, this study has echoed voices of married adolescent girls on the sexual troubles they experience. Their main concern is that they suffer sexual coercion in silence, which increases their risk of acquiring sexually transmitted infections and/or unwanted pregnancies. Recommendations for sexual violence prevention strategies are discussed.

Childhood Trauma, Gender Inequitable Attitudes, Alcohol Use and Multiple Sexual Partners: Correlates of Intimate Partner Violence in Northern Tanzania

Intimate partner violence (IPV), including physical, sexual, emotional, and economic violence, has profound immediate and long-term effects on individuals and communities worldwide. To date, few studies have focused on couples' reporting of IPV. The aim of this article is to present the results of a survey of couples' reporting of IPV and the individual, interpersonal, and social correlates of IPV in northern Tanzania. Four hundred fifty couples from Karatu District, Tanzania, completed a questionnaire measuring attitudes on gender norms and relations, men's experience of childhood trauma, and men's perpetration and women's experience of IPV. We found high levels of acceptance and experience of IPV: 72% of men justified a husband's perpetration of IPV, and 54% of men and 76% of women said that a woman should tolerate violence to keep her family together. The majority of women had ever experienced IPV (77.8%), and 73.6% and 69% had experienced IPV in the past 12 and 3 months, respectively. Men were significantly less likely to report that they had committed IPV: 63.6% ever, 48.9% in the past 12 months, and 46.2% in the past 3 months. Multivariate logistic regression found that younger men, men who reported gender inequitable attitudes, childhood trauma, multiple sexual partners, and alcohol use were significantly more likely to report IPV perpetration in the past 3 months. Younger women, and women with low levels of education and reported food shortages were significantly more likely to report IPV in the past 3 months. These results indicate that social and individual acceptance and justification of IPV are common. Experience of violence persists over time in many relationships. This study demonstrates the need for interventions that address individual-, interpersonal-, and community-level determinants of IPV, including attitudes regarding gender equity, exposure to violence as children and intergenerational violence, lack of education, and poverty.

Prevalence and factors associated with intimate partner violence after HIV status disclosure among pregnant women with depression in Tanzania

Intimate partner violence (IPV) exacts a heavy burden on women, resulting in poor health outcomes. This study had the following aims: (1) estimate the prevalence of IPV post-disclosure of HIV status among pregnant women living with HIV and depression; and (2) evaluate risk and protective factors for IPV post-disclosure. Participants were women accessing PMTCT services at 16 health facilities in Dar es Salaam and screened at the threshold of 9 on the PHQ-9. Generalized linear equations with a log link and standard errors clustered at the facility level were used to calculate associations between predictors and IPV post-disclosure. Among 659 women who were in an intimate relationship, 10.2% had experienced physical violence and 11.6% had reported sexual violence from their partner in the past six months; 327 had disclosed their HIV status to their partners. After disclosure to their partners 279 women (85.3%) experienced IPV. HIV-related stigma was associated with increased risk of IPV following disclosure and appreciative relationships with partners and higher hope were associated with reduced risk of IPV. There is a need to identify and advance approaches to HIV disclosure that prevent IPV. Interventions should be developed based on known risk and protective factors for IPV following HIV disclosure in Tanzania and similar settings.

Correlates of intimate partner violence among married women in Uganda: a cross-sectional survey

BACKGROUND

In Uganda, just like in many sub-Saharan countries, studies on Intimate Partner Violence (IPV) among married women are limited. The aim of this paper was to determine the correlates of emotional, sexual, physical IPV and any form of IPV among married women in Uganda.

METHODS

The 2016 Uganda Demographic and Health Survey (UDHS) data was used, and a weighted sample of 6879 married women were selected from the Domestic Violence module. Frequency distributions were used to describe the characteristics of respondents. Chi-square tests were used to establish the association between IPV and the explanatory variables. Binary logistic regressions were used to establish the factors that were associated with IPV among married women in Uganda.

RESULTS

More than half (56%) of the married women experienced some form of IPV. Sexual IPV was the least prevalent (23%) and 4 in 10 women (41 and 40%) experienced physical and emotional IPV, respectively. Factors associated with all the different forms of IPV included, age, region, witnessing parental violence, partner's controlling behaviors, duration of the relationship, and frequency of intoxication of the male partner.

CONCLUSION

IPV among Ugandan married women is far too common. This calls for collective efforts to reduce IPV in Uganda by addressing excessive alcohol consumption, controlling behaviors, and lack of awareness of the issue. Interventions aimed at preventing perpetration and tolerance of violence in the home settings should be promoted.

Engaging Young Men as Community Health Leaders in an STI and Intimate Partner Violence Prevention Trial in Dar es Salaam, Tanzania

BACKGROUND

This article presents lessons learned from a microfinance and health intervention for young men designed to prevent sexually transmitted infections (STI) and intimate partner violence (IPV) in Dar es Salaam, Tanzania. We describe the different strategies we used to identify and train young men to become change agents within their social networks.

DESCRIPTION

A cluster-randomized trial with 60 camps was undertaken in the Kinondoni District of Dar es Salaam. A total of 170 members from 30 intervention camps were trained in March 2014 as popular opinion leaders (POLs), whom we call Camp Health Leaders (CHLs). We describe the process of nominating, training, and retaining CHLs. We also describe our monitoring process, which included the collection of weekly diaries assessing topics discussed, number of peers engaged in conversations, reactions of peers, and challenges faced.

LESSONS LEARNED

POLs within naturally existing social networks can be engaged in STI and IPV prevention initiatives. Continuous efforts in retention, such as holding community advisory board (CAB) meetings, developing prevention slogans and t-shirts, and offering small grants to POL teams for intervention activities, were important to keeping POLs engaged in the intervention. Further, booster-training sessions were critical to maintain the message of the project and ensure that the challenges POLs face with implementing the programs were addressed in a timely manner.

CONCLUSION

Recruiting POLs in a Tanzanian urban setting and engaging them in STI and IPV reduction through social networks is possible. Training POLs in health information and interpersonal communication is important. Utilizing booster sessions and a variety of retention strategies for POLs in programs that aim to reduce IPV and STI infections among young men is essential to maintain the health leaders' engagement in the intervention as well as intervention fidelity.

Prevalence and correlates of partner violence among adolescent girls and young women: Evidence from baseline data of a cluster randomised trial in Tanzania

Background

Little has been documented about partner violence among adolescent girls and young women (AGYW) who are out of school, a factor associated with HIV acquisition. To understand areas for prioritising HIV prevention intervention efforts, we explored the prevalence and correlates of partner violence among out of school AGYW in Shinyanga, Tanzania.

Methods

A cross-sectional analysis of data from AGYW aged 15–23 years recruited in a cluster randomised trial conducted between October and December 2017 was used to examine correlates of partner violence. Data were collected through an Audio Computer-Assisted Self-interview. Multivariate logistic regression analysis was used to evaluate the association.

Results

2276 (75.5%) AGYW were sexually active. Of these, 816 (35.9%) reported having experienced violence from partners in the last six months. After adjusting for other covariates, being formerly married (AOR = 1.55, 95% CI:1.02, 2.37), having children (AOR = 1.79, 95% CI:1.47, 2.16), anxiety and depression symptoms (AOR = 3.27, 95%CI: 2.15, 4.96), having engaged in sex work in the past six months (AOR = 1.92, 95% CI: 1.45, 2.53) and economic deprivation (AOR = 1.61, 95% CI: 1.34,1.92) were significantly associated with partner violence.

Conclusions

Almost one in three sexually active AGYW had experienced partner violence in the 6 months preceding the survey. The findings underscore the need for future research to focus on understanding the reasons and dynamics underlying high level of partner violence among AGYW. Furthermore, there is a need for implementing intervention programs that aim to reduce economic deprivation among AGYWs and address social norms and structures perpetuating violence against AGYW.

Trial registration

ClinicalTrials.gov—IDNCT03597243.

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

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.

Electronic supplementary material

The online version of this article (10.1186/s12978-019-0726-5) contains supplementary material, which is available to authorized users.

Intimate partner violence victimization increases the risk of under-five morbidity: A stratified multilevel analysis of pooled Tanzania Demographic Health Surveys, 2010-2016

INTRODUCTION

A hidden determinant such as intimate partner violence victimization has been associated with under-five morbidity and mortality. However, there is lack of information regarding which exactly age group of under-five is more vulnerable to morbidity when their mothers exposed to intimate partner violence victimization. This study aimed to determine the effect of mothers' exposure to intimate partner violence victimization on age groups specific under-five morbidity that could lead to mortality.

MATERIAL AND METHODS

The current study pooled and analyzed data from 2010 and 2016 Tanzania Demographic Health Survey datasets. We used a stratified multilevel modeling to assess the association between under-five morbidity and intimate partner violence victimization according to age groups. The Statistical approach using Stata 14 was used to adjust for clustering effect and weighted the estimates to correct for non-responses and disproportionate sampling employed during designing of the surveys.

RESULTS

A total of 13,639 singleton live-births babies within three years prior to interview dates from the ever-married women were included in the analysis. We found a significant reduction of the three main symptoms of under-five morbidity namely; a cough with difficult or fast breathing from 21.7 to 15.7%, fever from 22.5 to 18.3%, and diarrhoea from 15.5 to 12.7% for the survey years from 2010 to 2016 respectively (P<0.05). Overall, about 40% of mothers reported experiencing any forms of intimate partner violence victimization. After adjusting for individual and cluster variables, we found that under-five in post-neonatal period (Adjusted odds ratios = 1.50; 95%CI, 1.21-1.86) and childhood period (Adjusted odds ratios = 1.40; 95%CI, 1.24-1.57) were significantly affected with morbidity when their mothers' exposed to any form of intimate partner violence victimization.

CONCLUSION

This analysis revealed that intimate partner violence victimization is still a major and public health problem in Tanzania that threatens child health during the period of post-neonatal and childhood. There is a need to introduce screening for intimate partner violence victimization in maternal and child care for effective monitoring and prevention of the problem.

"Staying for the children": The role of natal relatives in supporting women experiencing intimate partner violence during pregnancy in northern Tanzania - A qualitative study

INTRODUCTION

Intimate partner violence (IPV) is a global health and human rights problem. In Tanzania, national studies have shown that half of all women experience partner violence in their lifetime, 38% reported being abused during a period of 12 months and 30% during pregnancy. Despite the benefits of social support to women victims of violence during pregnancy, a majority of women hesitate to seek help and, if they do, they mainly turn to their natal relatives for support. However, this process of help-seeking and the type of support received is not well documented and needs to be explored with a view to future interventions. This article investigates women's own perspectives on the support they receive from natal relatives when experiencing IPV during pregnancy.

MATERIALS AND METHODS

Eighteen participants who experienced physical IPV during pregnancy were purposively selected from a cohort of 1,116 pregnant women enrolled in a project that aimed at assessing the impact of intimate partner violence on reproductive health. In-depth interviews were used to explore the social support received from the natal family among women who experienced partner violence during pregnancy. All interviews were audio recorded, transcribed, coded and analyzed.

RESULTS

Women who experienced severe IPV during pregnancy were more likely to seek help from natal relatives. Severe violence was defined by the women as acts that occurred frequently and/or resulted in injury. The women's natal relatives were willing to provide the support; however, they strongly encouraged women to maintain their marriage so that they could continue caring for their children jointly with their partners. Emotional support was the commonest form of support and included showing love and empathy and praying. Information provided to victims aimed mainly at advising them to maintain their marriage. Practical support included direct financial support and building their economic base to reduce dependency on their partners. When the couple was on the verge of separation, mediation was provided to save the marriage.

CONCLUSION

Women who experienced partner violence preferred to seek help from their natal relatives. The support provided by natal relatives was beneficial; however, maintaining the marriage for the care of children and family was given the highest priority, over separation. As a consequence, many women continued to live with violence. Stakeholders supporting victims of violence need to understand the priorities of victims of violence and structure intervention to address their needs.

Unwanted pregnancy, pregnancy loss, and other risk factors for intimate partner violence in the Democratic Republic of the Congo

The Democratic Republic of the Congo (DRC) has one of the highest rates of violence against women in the world; however, few studies have focused on this issue. In this study, we assessed the interrelationship among intimate partner violence (IPV), unintended pregnancy, pregnancy loss, and other sociodemographic factors in the DRC. Our analyses were based on data from the DRC demographic and health survey, conducted from November 2013 to February 2014. We constructed generalized estimating equation models to analyze the data from a sample of 5,120 married women. Our results showed that having a husband or partner who exhibited controlling behaviors, women who justified wife-beating, having a mother who had experienced IPV, and having a husband or partner who consumed alcohol were positively associated with IPV, whereas decision-making autonomy among women was negatively associated with IPV. In the community, the proportion of women who had experienced IPV and that of those who had completed secondary or higher education were positively and negatively associated with any IPV type, respectively. In addition, emotional IPV and any IPV type were positively associated with pregnancy loss. Our results indicate the necessity of implementing programs targeting gender equality at both individual and community levels.