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

Misperception of Norms About Intimate Partner Violence as a Driver of Personal IPV Attitudes and Perpetration: A Population-Based Study of Men in Rural Uganda

Intimate partner violence (IPV) against women is a global public health problem. Conceptual frameworks suggest misperceived norms around IPV might drive perpetration of violence against women in southern and eastern Africa. We conducted a cross-sectional, population-based survey of all men residing in a rural parish in southwest Uganda, eliciting their endorsement of IPV in five hypothetical scenarios and their reported frequency of perpetration of violence against their wife/main partner. They also reported their perceptions about the extent to which most other men in their villages endorsed and/or perpetrated IPV, which we compared against the population data to measure the primary explanatory variable of interest: whether individuals misperceived norms around IPV. We fitted multivariable Poisson regression models specifying personal IPV endorsement and IPV perpetration as the outcomes. Overall, 765 men participated in the study (90% response rate): 182 (24%) personally endorsed IPV, and 78 of 456 partnered men (17%) reported perpetrating one or more acts of IPV at least once per month. Although most men neither endorsed nor reported perpetrating IPV, 342 (45%) men mistakenly thought that most other men in their villages endorsed IPV and 365 (48%) men mistakenly thought that most other men perpetrate IPV at least monthly. In multivariable regression models, men who misperceived most men to endorse IPV were more likely to endorse IPV themselves (adjusted relative risk [aRR] = 2.44; 95% CI [1.66, 3.59]; p < .001). Among partnered men, those who misperceived IPV perpetration to be normative were more likely to perpetrate IPV themselves (aRR = 4.38; [2.53, 7.59]; p < .001). Interventions to correct misperceived norms about IPV may be a promising method for reducing violence against women in rural Uganda.

Multilevel analysis of intimate partner violence and associated factors among reproductive-age women: Kenya demographic and health survey 2022 data

INTRODUCTION

Intimate partner violence is a human rights violation that often involves violence against women, which appears to be the most prevalent type of abuse. Intimate partner violence is a major global public health issue that includes physical, emotional, and sexual violence. The prevalence of intimate partner violence in Africa is high. The burden of intimate partner violence among reproductive-age women is high in Kenya. Therefore, the main aim of this study is to determine the associated factors of intimate partner violence among reproductive-age women at the individual and community level from the recent Demographic and Health Survey (DHS) 2022 data of Kenya.

METHODS

The Kenya National Demographic and Health Survey data of 2022 was used for this study. The overall sample size for this study was 14,612, which focused on women aged 15 to 49 years who had ever been partnered and responded to the domestic violence module. Multilevel logistic regression models to determine the prevalence and associated factors at the individual and community level with intimate partner violence with a 95% Confidence Interval (CI) and Adjusted Odds Ratio (AOR).

RESULT

The overall prevalence of intimate partner violence was 41.1% with a 95% CI (40.07%, 42.60. Male-headed households, poorest and middle wealth status, partner alcohol use, separated/widowed current marital status, and low education of women were statistically significantly associated with intimate partner violence at the individual level variables in this study.

CONCLUSIONS

The prevalence of intimate partner violence was high. Educating women, reducing partner alcohol use, and improving the economic status of women, were crucial in mitigating the burden of intimate partner violence. The intimate partners are supposed to respect the rights of women.

Toward Ending Violence Against Women: The Association of Intimate Partner Violence With Food Security Status Among Ever-Married Women in Cameroon

Despite an extensive body of literature that explores potential mechanisms explaining the factors associated with intimate partner violence (IPV) experienced by women, very few studies have studied the association of food security status with women's experience of IPV in sub-Saharan Africa countries, including Cameroon. Using data from the 2018 Cameroon Demographic and Health Survey (n = 4,690), we explore the association between food security status and three distinct forms of IPV (i.e., emotional, sexual, and physical IPV) among ever-married women in Cameroon. Adjusting for socioeconomic, demographic, and attitudinal and behavioral characteristics, we found that women with severe (odds ratio [OR] = 2.09, p < .01), moderate (OR = 1.88, p < .05), and mild (OR = 1.76, p < .05) food insecurity were more likely to experience sexual IPV, compared to those without any food insecurity, whereas women with severe food insecurity were more likely to experience physical IPV (OR = 1.89, p < .001). Although women with severe (OR = 1.51, p < .01) and moderate (OR = 1.67, p < .001) food insecurity had a higher likelihood of experiencing emotional IPV at a bivariate level, we found that these associations became no longer significant in our adjusted model. These findings suggest that food insecurity is a critical risk factor for IPV among ever-married women in Cameroon. Addressing IPV requires a comprehensive strategy that places special emphasis on households experiencing food insecurity. There is also an urgent need to implement educational programs to increase awareness of the interconnection between food insecurity and IPV and to allocate resources to community-based initiatives that empower women both economically and socially.

Intimate Partner Violence, prevalence and its consequences: a community-based study in Gambella, Ethiopia

Abstract

Introduction

Intimate partner violence is defined as any behavior by a current or past male intimate partner during marriage, cohabitation, or any other formal or informal union that causes physical, sexual, or psychological harm. Men are the most common perpetrators of this against women. It affects almost one-third of all women worldwide.

Objective

This study aimed to assess the prevalence, consequences, and factors associated with intimate partner violence among partnered women in Gambella town.

Methods

A community-based, cross-sectional study design was employed. A systematic random sampling technique was used to select the study participants. Data was collected using a pretested, structured questionnaire. The data were entered and analyzed using SPSS software version 25. The bivariate and multivariate logistic regression method was used to identify factors associated with intimate partner violence. Variables with a p-value <0.05 were considered significantly associated with intimate partner violence.

Results

The overall prevalence of intimate partner violence in the lifetime and the last 12 months was 58.8, 95% CI (54.0, 63.6), and 51.8, 95% CI (46.7, 56.8), respectively. More than half (53.3%) of the violence resulted in physical injury, while 32.9% were separated from their partners whereas, mother's history of exposure to IPV [AOR: 1.8, 95% CI (1.03-3.27), p < 0.05], respondent's age [AOR: 3.4, 95% CI (1.8, 6.5), p < 0.001], substance use [AOR:2.5, 95% CI (1.5-4.1), p < 0.001], disagreement on sexual intercourse [AOR:3.2, 95% CI (1.8-5.7), p < 0.01], monthly family income [AOR:0.32, 95% CI: (0.16-0.63), p < 0.01] and family size [AOR:2.8, 95% CI: (1.6-4.8), p < 0.01] were significantly associated with IPV.

Conclusion

The study indicated that the prevalence of intimate partner violence was very high. Age of the woman, family size, substance use, economic status, were among factors significantly associated with intimate partner violence. Therefore, responsible stakeholders should respond to the deep-rooted and highly complicated gender inequality by implementing preventive measures.

Multi-level analysis of intimate partner violence and its determinants among reproductive age group women in Ethiopia: evidence from Ethiopian Demographic Health Survey, 2016

BACKGROUND

Intimate partner violence (IPV) is recognized as a main public health challenge, with serious consequences for women's physical, mental, sexual, and reproductive health. Despite its public health importance, most studies of IPV in Ethiopia mainly focused on individual characteristics and didn't identify how factors operating at different levels affect IPV. Thus, there is limited evidence regarding the hierarchical-level factors of IPV and the effect of individual and community-level determinants of IPV. The aim of this study is to assess the individual and community-level factors associated with violence against women among ever-married reproductive-age women in Ethiopia.

METHODS

A retrospective analysis of secondary data retrieved from the Ethiopia Demographic and Health Survey was conducted among reproductive age group women (15-49 years of age) who reported ever being married within the available data set for the domestic violence module. STATA 14 was used to conduct the analysis. A two-level mixed-effects logistic regression analysis was used to determine associations between IPV and individual- and community-level factors. IPV variability across the community was assessed using ICC and PCV. The model's fitness was assessed using the Akaike information criterion (AIC), the Bayesian information criterion (BIC), and the likelihood ratio test.

RESULT

The life time prevalence of IPV in this study was 33% [95% CI: 30.74, 34.25]. Women's age 20-24 (AOR = 5.85, 95% CI: 201 3.10, 11.04), 25-29 age group (AOR = 6.41, 95% CI; 3.34, 12.32), 30-34 age group (AOR = 9.48, 95% CI: 4.71, 19.06), 35-39 age group (AOR = 9.88, 95% CI: 4.79, 20.39), 40-44 age group (AOR = 11.10, 95% CI: 5.16, 23.89), and 45-49, (AOR = 14.15, 95% CI: 6.01, 32.80), early marriage (AOR = 1.21, 95% CI: 1.08, 1.47), witnessing inter-parental violence during childhood (AOR = 2.80, 95% CI: 2.16, 3.96), having a lot of living children (AOR = 0.45, 95% CI: 0.26, 0.74), having a partner who drank alcohol (AOR = 3.00, 95% CI: 2.42-3.67), decision-making autonomy of the women (AOR = 0.77, 95% CI: 0.62, 0.97), Poor wealth index (AOR = 1.64, 95% CI: 1.23, 2.18), middle wealth index (AOR = 1.86, 95% CI: 1.36, 2.54) and exposure to media (AOR = 1.47, 95% CI: 1.06, 2.00) were all significantly associated with IPV.

CONCLUSION AND RECOMMENDATION

This study showed that one-third of the women experienced IPV in their lifetime. The finding suggested that community based interventions and multi-sectorial collaborations are needed to reduce the IPV and its adverse consequences.

Correlates of Intimate Partner Violence Victimization and Perpetration in Adolescents and Young Adults in Sub-Saharan Africa: A Systematic Review

Intimate partner violence (IPV) is a global public health crisis with long-term adverse consequences for both victims and perpetrators. Patterns of violence often begin during adolescence, yet most interventions target adult relationships. A systematic review was conducted to identify correlates of IPV victimization and perpetration among adolescents and young adults in sub-Saharan Africa (SSA). Eligible studies included participants 10 to 24 years old, took place in SSA, and tested a statistical association between a correlate and an IPV outcome. Correlates were defined as any condition or characteristic associated with statistically significant increased or decreased risk of IPV victimization or perpetration. PsycInfo, PubMed, Embase, and African Index Medicus were searched and included studies published between January 1, 2000 and February 4, 2022. The search resulted in 3,384 original studies, of which 55 met inclusion criteria and were analyzed. Correlates were first qualitatively synthesized by developmental period (e.g., early adolescence, older adolescence, and young adulthood) and then organized in a conceptual framework by correlate type (e.g., socio-demographic; health, behavior, and attitudes; relational; or contextual). Over two decades of literature reveals variability in evidence by developmental period but also substantial overlap in the correlates of victimization and perpetration. This review identifies multiple points for intervention and results suggest the urgent need for earlier, developmentally appropriate prevention efforts among younger adolescents as well as combined approaches that target both victimization and perpetration of IPV.

The link between intimate partner violence and spousal resource inequality in lower- and middle-income countries

OBJECTIVE

There is an increasing need to understand how differential levels of resource inequality between spouses are associated with women's experience of intimate partner violence (IPV) in lower- and middle-income countries across four regions. This study aims to focus on four areas of relative power and resources between couples in a partnership: employment, job skills, earnings, and household making-decision across four lower- and middle-income regions.

METHOD

Data on 150,623 women was drawn from the most recent, harmonized Demographic and Health Survey (DHS) for 24 countries in West-Central Africa (WCA), East-Southern Africa (ESA), Middle East and North Africa (MENA), and South Asia (SA). Leveraging an event history framework, we fitted mixture cure models to illuminate both the likelihood of never experiencing IPV and the onset of IPV among women in their first union across the four regions.

RESULTS

We found that women who are not in the labor market are less likely to experience violence compared to those who are in all places except MENA. Among couples in which both partners are in the labor market, women with lower job skills than their partner are less likely to experience violence. Inequality in earnings is associated with the onset of intimate partner violence in ESA and SA. Similarly, inequality in household decision-making is associated with the onset of the first spousal violence but only in ESA, MENA, and SA.

CONCLUSION

This study found vast heterogeneity in the different measures of spousal resource inequality and women's experience of IPV across LMIC settings. This underscores the imperative for interventions focused on enhancing women's economic outcomes to consider and confront the contextual norms associated with women's economic empowerment, in order to mitigate unintended adverse consequences.

Predictors for the utilization of community support systems against intimate partner violence among married women living with HIV in southwestern Uganda-A cross sectional study

BACKGROUND

Intimate partner violence (IPV) disproportionately affects married women living with HIV (MWLHIV), resulting in undesirable human rights, socio-economic, mental, maternal, and child health consequences. Community Support systems against Violence (CoSaV) are widely available and promising public and voluntary resources for the prevention and mitigation of IPV but are poorly investigated. We set out to identify the predictors for the utilization of the CoSaV among the MWLHIV.

METHODS

This was a quantitative cross-sectional study conducted among 424 consecutively sampled MWLHIV attending the Antiretroviral Therapy (ART) clinic at Kabale Regional Referral Hospital in southwestern Uganda in April 2021. Using an interviewer-administered questionnaire, data were collected on the participant's socio-demographic characteristics, exposure to IPV, awareness about the CoSaV, perceptions about the quality, accessibility and challenges in accessing the CoSaV and the utilization. Modified Poisson regression model was used to identify the predictors for the utilization of CoSaV using the Statistical Package for Social Sciences (SPSS) version 23.0.

RESULTS

The mean age of the 424 participants in the study was 39.5 ± 10.2 years. More than half of the participants 51.9% (220/424) reported exposure to any IPV. Utilization of any CoSaV was found to be above average at 58.3% among the participants. The formal support (police, local government leaders, health workers and counselors) were more frequently utilized compared to the informal support (family, relatives and friends). Utilization of any CoSaV was higher among the women who were aware of the CoSaV and also those who were exposed to violence. Accessibility was identified as an independent predictor for utilization of any CoSaV.

CONCLUSIONS

Intimate partner violence (IPV) was prevalent among MWLHIV in southwestern Uganda. However, the utilization of any CoSaV was suboptimal. The formal CoSaV were more frequently utilized than the informal support systems. Accessibility was an independent predictor for utilization of any CoSaV. There is need to improve access in order to increase the utilization of the CoSaV and contribute to the attainment of sustainable development goal 5.2.1 and end violence against women.

Prevalence, Correlates, and Trends of Intimate Partner Violence Against Women in Cambodia: Findings From 2014 and 2021-22 Cross-Sectional Demographic and Health Surveys

Intimate partner violence (IPV) is globally endemic and a gross violation of human rights, in addition to abuse of intimacy by some men against their female intimate partners. Based on literature review, attitudinal, socio-demographic, and experiential attributes of 15 to 49 year old ever partnered women in the heterosexual relationships were identified. This study used the anonymized 2020-21Cambodia Demographic and Health Survey (CDHS) data to compute the IPV prevalence and its correlates, in addition to computing the changes in IPV prevalence at the urban, rural, and at the national levels using data from the 2014 CDHS. Identified attitudinal, socio-demographic, and experiential attributes were used in the bivariate and multivariable analysis. Simple and multiple logistic regression models were used for computing the bivariate and multivariate associations with IPV; additionally, trend analysis was done to compute changes in IPV prevalence between the 2 surveys. Lifetime prevalence of IPV was 20.70%, while the most common subtype was emotional IPV at 18.70%. Ten out of 12 correlates studied were found to be statistically significantly associated with IPV in the bivariate analysis. These were added in the multivariable model and 7 were found to be statistically significantly associated with IPV. Which included educational attainment of women and their intimate partners, number of living children, women's IPV acceptance, male partner's alcohol use, knowledge of physical beating of mother by one's father, and controlling behavior exercised by partner. During the intervening period between the 2 CDHSs, IPV and its subtypes were decreased in both urban and rural areas, as well as nationally. IPV decrease between the 2 DHSs and lower IPV rates in 2021-22 augur well for the health and human rights of Cambodian women. However, the ultimate target of eliminating IPV against women, will require measures that ensure economic and gender empowerment, and gender equality.

Correlates of Intimate Partner Violence Among Young Women Engaged in Sex Work in Southern Uganda

Intimate partner violence (IPV) is a significant global public health problem that results in high social and economic costs to individuals and communities. Compared to women in the general population, women engaged in sex work (WESW) are more likely to experience physical, emotional, and sexual IPV. This study examines the correlates of IPV among young WESW with their intimate partners in Southern Uganda. We used baseline data from the Kyaterekera project, a 5 year NIH-funded longitudinal study aimed at reducing HIV risks among 542 WESW in Southern Uganda. To examine the factors associated with IPV, we fitted three separate multi-level Poisson regression models for physical, emotional, and sexual IPV, respectively. Average age was 31.4 years, and 54% of the women reported being victims of at least one form of IPV from their intimate partners. Model one assessed correlates of sexual IPV. Being married women (β = .71, 95% CI [0.24, 1.17]), divorced/separated/widowed (β = .52, [0.02, 1.02]), depressed (β = .04, [0.02, 0.05]), and having any sexually transmitted infections (STIs) (β = .58, [0.14, 1.01]) were associated with sexual IPV. Model two assessed correlates of physical IPV. Experience of childhood sexual abuse (β = .12, [0.04, 0.19]) was associated with an increase in physical IPV, and increasing age reduced its occurrence (β = -.02, [-0.04, -0.001]). Finally, model three assessed emotional IPV. Women with higher education (β = .49, [0.14, 0.85]) and symptoms of depression (β = .02, [0.001, 0.04]) had higher risks for emotional IPV. For WESW, IPV presents an additional potential pathway for HIV and STIs acquisition and transmission through a lack of negotiating power for safe sex. Efforts to reduce violence against WESW should be prioritized as a strategy for enhancing the well-being of WESW.

Intimate partner violence and its associated factors among reproductive-age women in East Africa:-A generalized mixed effect robust poisson regression model

BACKGROUND

The World Health Organization (WHO) has published estimates revealing that around one out of every three women across the globe has been a victim of either physical and/or sexual violence from an intimate partner or non-partner throughout their lifetime. The available evidence on intimate partner violence in East Africa is limited Consequently, the objective of this study was to evaluate the occurrence and factors linked to intimate partner violence in East Africa.

METHODS

The study utilized the most recent data from the Demographic and Health Surveys (DHS) conducted between 2011 and 2018/19 in 11 countries in Eastern Africa. A total of 59,000 women were included in the study. Descriptive and inferential statistics were used to exmine factors associated with IPV. A mixed effect robust Poisson regression model was fitted to identify factors associated with intimate partner violence. The adjusted prevalence ratio (aPR) and its corresponding 95% confidence interval (CI) were employed to determine the presence of a significant association between intimate partner violence and the independent variables.

RESULTS

In this study, the prevalence of intimate partner violence in East Africa was 43.72% with 95% CI 43.32% to 44.12%. In the mixed effect robust Poisson regression model:-Marital status, working status, parity, sex of household headed, wealth index, community poverty, and residence, were significantly associated with intimate partner violence.

CONCLUSION

The prevalence of intimate partner violence in East Africa is high as compared to the global prevalence 30%, which hinders The Sustainable Development Goals (SDGs), specifically goal 5, aim to attain gender equality and empower women and girls worldwide by the year 2030 Women being previously married and cohabitated, working, having a high number of children, rural residents were positively associated with IPV and household and community wealth index and sex of household headed were negatively related with IPV in East Africa. Therefore, we recommend establishing effective health and legal response using an integrated policy approach and Special attention should be given to women who live rural and poorest to reduce IPV and to achieve Sustainable Development Goals (SDGs) goal 5.

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

OBJECTIVE

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

SETTING

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

RESULTS

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

CONCLUSIONS

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

Determinants of spousal physical violence against women in Zambia: a multilevel analysis

BACKGROUND

Violence against women and girls is a major public health issue, a violation of human rights, and is linked to a number of harmful effects on one's physical, mental, sexual, and reproductive health. Studies conducted in other parts of sub-Saharan Africa (SSA) suggest that there is an association between contextual factors and experience of intimate partner violence. However, in Zambia, this association is not well documented. Thus, this study was conducted to examine how individual and community-level characteristics influence spousal violence against women in Zambia.

METHODS

Data from the most recent Zambia Demographic and Health Survey conducted in 2018 was used. A sample of 7,358 ever-married women aged 15-49 years was used in the analysis. Two level multilevel binary logistic regression models were employed to examine the association between individual and contextual-level factors and experience of spousal violence.

RESULTS

The prevalence of spousal physical violence against women in Zambia was 21.1% [95% CI, 19.8, 22.5]. Women aged 15-19 [aOR = 2.36, 95% CI = 1.34-4.14] and 20-24 [aOR = 2.11, 95% CI = 1.38-3.22], who did not own mobile phone [aOR = 1.36, 95% CI = 1.10-1.69], and had low decision making autonomy [aOR = 1.24, 95% CI = 1.01-1.54] were more likely experience spousal physical violence. Furthermore, communities which had a low proportion of women with decision making power [aOR = 1.66, 95% CI = 1.26-2.19] were more likely experience spousal physical violence. Additionally, women whose partners' drank alcohol [aOR = 2.81, 95% CI = 2.30-3.45] and those whose partners exhibited jealous behaviour [aOR = 2.38, 95% CI = 1.88-3.21] were more likely to experience spousal physical violence.

CONCLUSION

Both individual and community-level factors influenced spousal physical violence in Zambia. Integrating community level factors when designing interventions to address gender-based would be key to reduce women's vulnerability to gender based violence in the country. There is need to re-evaluate and re-strategize current strategies being implemented to address gender based violence in the country to make them context specific.

Factors associated with elder abuse and neglect in rural Uganda: A cross-sectional study of community older adults attending an outpatient clinic

BACKGROUND

Elderlies are vulnerable to abuse, and evidence suggests that one in three elderlies experience abuse. Abuse can impact the well-being of older persons, decreasing their quality of life, leading to mental health challenges, and increasing morbidity and mortality rates. Evidence on older person/elder abuse and neglect is vital to facilitate initiatives, but there are fewer studies on elder abuse and neglect in Africa, particularly in Uganda. Thus, this study aimed to determine the prevalence of different types of abuse and neglect, and their associated factors among older persons (aged 60 years and above) attending an outpatient clinic.

METHODS

In this cross-sectional study, information on sociodemographic characteristics, functional impairment using the Barthel Index, and elder abuse severity using the Hwalek-Sengstock Elder Abuse Screening Test were collected. In addition, types of abuse were assessed using questions adapted from the US National Research Council on elder mistreatment monograph. Linear and logistic regression analyses were used to determine the factors associated with elder abuse severity and the different types of abuse, respectively.

RESULTS

Overall, the prevalence of elder abuse was 89.0%. Neglect was the most common type of elder abuse (86%), followed by emotional abuse (49%), financial abuse (46.8%), physical mistreatment (25%), and sexual abuse (6.8%). About 30.4% of the abused elders experienced at least two forms of abuse. Factors associated with elder abuse severity were having a secondary level of education and physical impairment. Moderate to severe functional dependence was associated with almost all forms of abuse. Individuals who reported the presence of a perpetrator were likely to experience neglect, emotional, and physical mistreatment. However, those who reported their perpetrators to the police had a higher likelihood of experiencing emotional abuse but were less likely to experience financial abuse. Emotional abuse was also associated with age above 80 years and attaining education (primary and secondary). Physical impairment and chronic medical conditions reduced the likelihood of experiencing neglect and financial abuse, and physical abuse, respectively.

CONCLUSIONS

Uganda has a high prevalence of elder abuse and neglect. There is a need to design interventions for older adults at risk to prevent elder abuse from escalating further, where the present findings can be worthy of help.

Assessing the social patterning and magnitude of inequalities in sexual violence among young women in Uganda: Findings from 2016 demographic and health survey

Sexual violence (SV) is a significant global public health problem. To develop effectively targeted interventions to prevent SV and allocate resources equitably requires identifying the most vulnerable groups and the magnitude of these social inequities. However, these data are currently lacking. Using the Uganda Demographic and Health Survey, we examined SV among all young women and ever-married young women. We conducted univariate and bivariate analyses to characterise the prevalence and social patterning of SV, and then utilised the World Health Organization Health Equity Assessment Toolkit (HEAT) to assess the magnitude of social inequities in SV. At the national level, 5.5% among all young women and 20.5% of ever-married young women had experienced SV. For all young women, the largest inequities in SV were based on sub-national region of residence. Among the ever-married young women, we found profound education, wealth and place-based inequities in SV, which favoured young women with higher education, in wealthier households, and within central regions of Uganda. Our findings suggest a need for regionally targeted multi-sectoral interventions that take into consideration that multiple intersecting social dimensions such as education, poverty and the safe built environment, to address young women's risk for SV.

Ugandan Men Exposed to Intimate Partner Violence: A Cross-Sectional Survey of Nationally Representative Data

Although women typically constitute the largest proportion of the population who experience the deleterious effects of intimate partner violence (IPV), understanding the bidirectional nature of IPV is important for developing nuanced prevention initiatives. This study examines data from the 2016 Ugandan Demographic and Health Survey. Participants were selected from households in all the 15 regions in Uganda using a two stage sampling design. A total of 2858 men who were in a heterosexual union or separated/divorced were included in the analysis. Univariate and multivariable logistic regression analyses were performed with the aim of identifying associations between selected demographic variables and male exposure to all forms of IPV combined, psychological violence, physical violence and sexual violence. The prevalence of lifetime IPV and during the 12 months preceeding the survey respectively was 43.6 and 30.5% in all forms, with 35.9 and 24.8% reporting psychological, 20.2 and 11.9% for physical and 8.2 and 5.7% sexual violence. The key factors associated with all forms of IPV were being afraid of their wife/partner most of the time (OR = 5.10, 95% CI 2.91, 8.96) controlling behaviour of the intimate partner (OR = 3.80, 95% CI 2.84, 5.07), bi-directional violence against the partner (OR = 3.20, 95% CI 2.49, 4.12), alcohol consumption by the intimate partner (OR = 1.85, 95% CI 1.40, 2.45). The factors associated with males who experience IPV appear to be modifiable and may warrant consideration for inclusion in programs supporting both males and females who experience IPV.

A Ugandan Parenting Programme to Prevent Gender-Based Violence: Description and Formative Evaluation

Purpose: To develop a culturally-sensitive intervention for the early prevention of gender-based violence (GBV) in Uganda. Methods: Programme design followed the 6SQuID model of intervention development and multi-sectorial advice. A formative evaluation was conducted in two communities with six groups and 138 participants. Findings: Four familial predictors of GBV were identified as potentially malleable: poor parent-child attachment, harsh parenting, inequitable gendered socialization and parental conflict. A community-based parenting programme was developed to address them. Its programme theory incorporates Attachment Theory, the concept that positive behavioural control develops emotional control, and Social Learning Theory. Its rationale, structure and content are presented using the TIDieR checklist. A formative evaluation showed the programme to be widely acceptable, culturally appropriate, and perceived to be effective, but also identified challenges. Conclusion: The careful development of this community-based parenting programme shows promise for the early prevention of GBV.

Intimate partner violence among reproductive-age women in central Gondar zone, Northwest, Ethiopia: a population-based study

BACKGROUND

Violence against women is the most widespread kind of human rights violation, and it has been linked to a wide range of consequences. The most prominent psychosocial and mental health concern that has serious effects for women's physical and mental well-being. This study assessed the prevalence and associated factors of women's violence by intimate partner among women in the reproductive age group (15-49).

METHODS

Multistage community-based cross-sectional study was conducted among reproductive age group women in the central Gondar zone. We recruited 845 participants and interviewed by health extension workers using face-to-face interviews. We used a Women's Abuse Screening test to outcome variable; it has a total score ranges 0-16, a score > 1 indicates positive for the presence of intimate partner violence within a year. Variables were coded and entered to Epi data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics and multivariate logistic regression analysis was run for data analysis. Adjusted odds ratios (AOR) with a 95% confidence level (CI) were declared significant.

RESULT

Among a total of 845 participants 804 responded to the interviews with a response rate of 95%. The prevalence rate of intimate partner violence is 391(48.6%). From multivariate logistic regression analysis women being married [AOR:3.85; 95% CI (2.38, 6.22)], high school and above educational status [(AOR: 0.43; 95% CI (0.30, 0.61), women's having > 3children [(AOR: 1.82, 95% CI (1.0, 3.1)], having a household food insecurity[(AOR: 2.09, 95% CI (1.51, 2.91)], having life threatening events [(AOR: 2.09; 95% CI (1.51, 2.91)], moderate social support [(AOR: 0.60; 95% CI (0.41, 0.83)], depression [(AOR: 3.12; 95% CI (1.60, 6.07) were significantly associated with violence by intimate partner at 95% CI .

CONCLUSION

Intimate partner violence is common among reproductive-age women. Married, women with several children, food insecurity, life-threatening events, and depression were all found to be significant predictors of violence. Measures should be taken to raise community awareness, particularly among intimate partners, their families, and government officials.

The evaluation of the subjection of married women to domestic violence in terms of submissive behaviors in Turkey: A descriptive study

PURPOSE

This study aimed to evaluate the subjection of married women living in the center of a city in Turkey to domestic violence in terms of submissive behaviors.

DESIGN AND METHODS

The study was descriptive and cross-sectional. The data were collected from married women (n = 7097) who volunteered to participate in the study and completed a survey form between September 2019 and February 2020.

RESULTS

Submissive behavior scores were high in the women subjected to physical violence, based on many characteristics, and the difference between groups was statistically significant (p < 0.05).

PRACTICAL IMPLICATIONS

Nurses should be active participants in the diagnosis, treatment, care, and rehabilitation processes of women who have suffered from violence and should support them in improving their coping skills.

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.

Risk factors for violence against women in high-prevalence settings: a mixed-methods systematic review and meta-synthesis

INTRODUCTION

Violence against women (VAW) affects one in three women globally. In some countries, women are at much higher risk. We examined risk factors for VAW in countries with the highest 12-month prevalence estimates of intimate partner violence (IPV) to develop understanding of this increased risk.

METHODS

For this systematic review, we searched PUBMED, CINAHL, PROQUEST (Middle East and North Africa; Latin America and Iberia; East and South Asia), Web of Science, EMBASE and PsycINFO (Ovid) for records published between 1 January 2000 and 1 January 2021 in English, French and Spanish. Included records used quantitative, qualitative, or mixed-methods, reported original data, had VAW as the main outcome, and focused on at least one of 23 countries in the highest quintile of prevalence figures for women's self-reported experiences of physical and/or sexual violence in the past 12 months. We used critical interpretive synthesis to develop a conceptual model for associations between identified risk factors and VAW.

RESULTS

Our search identified 12 044 records, of which 241 were included for analysis (2 80 360 women, 40 276 men, 274 key informants). Most studies were from Bangladesh (74), Uganda (72) and Tanzania (43). Several quantitative studies explored community-level/region-level socioeconomic status and education as risk factors, but associations with VAW were mixed. Although fewer in number and representing just one country, studies reported more consistent effects for community-level childhood exposure to violence and urban residence. Theoretical explanations for a country's high prevalence point to the importance of exposure to other forms of violence (armed conflict, witnessing parental violence, child abuse) and patriarchal social norms.

CONCLUSION

Available evidence suggests that heightened prevalence of VAW is not attributable to a single risk factor. Multilayered and area-level risk analyses are needed to ensure funding is appropriately targeted for countries where VAW is most pervasive.

PROSPERO REGISTRATION NUMBER

The review is registered with PROSPERO (CRD42020190147).

Prevalence and Correlates of Intimate Partner Violence among Women Attending Different Primary Health Centers in Aljouf Region, Saudi Arabia

Background and Objectives: Intimate partner violence (IPV) is a serious and widespread problem worldwide. IPV can seriously influence the physical, mental, sexual, and reproductive health of women as well as the welfare of their children. In the Middle East, IPV is pervasive and widely acceptable. The present study was done to determine the prevalence and correlates of IPV among women attending different primary health centers in the Aljouf region, Saudi Arabia. Methods: A cross-sectional study was conducted among 403 Saudi women attending different primary health centers in the Aljouf region, Saudi Arabia. A structured anonymous questionnaire was distributed to the targeted population during a face-to-face interview. Data analysis was done using the SPSS program, version 24. Results: The present study showed that 30.3% of the participants had been exposed to IPV over the last year. Concerning the types of violence, the present study revealed that emotional violence is the highest followed by physical and then sexual violence representing 92.6%, 67.2%, and 44.3%, respectively. The significant predictors of IPV were women with one to three children (OR = 7.322, p-value = 0.006), women with four children or more (OR = 13.463, p-value = 0.006), and women married to husbands with aggressive behavior (OR = 98.703, p-value < 0.001). Not taking the approval on marriage was significantly associated with more exposure to violence (OR = 3.190, p-value = 0.042). In addition, husband smoking status was a significant predictor for IPV (OR = 2.774, p-value = 0.012). However, women married to alcoholic drinkers had a significantly lower risk for exposure to IPV (OR = 0.108, p-value = 0.040). On the other hand, women’s age, marital status, women’s educational level, monthly income in RS, perception of income sufficiency, marriage duration, the age difference between women and their husband, and drug abuse status of the husband were not significant predictors of IPV (p-value ≥ 0.05). Sociocultural effects were the most frequent reason for IPV as reported by the participants (57.4%). The most common consequences of IPV were psychological problems (75.4%) and injuries (42.6%). Women’s reactions to IPV were leaving home (32.8%) or no reaction (36.8%) to retain their marriage. Conclusions: IPV remains an important public health problem among married women in this study area. Urgent interventions including educational and screening programs for Saudi women are required to mitigate the problem.

Adherence to COVID-19 preventive measures and its association with intimate partner violence among women in informal settings of Kampala, Uganda

Cases of coronavirus disease 2019 (COVID-19) detected, and COVID-19 associated mortality increased since the first case was confirmed in Uganda. While adherence to WHO-recommended measures to disrupt COVID-19 transmission has since been implemented, it has been reported to be sub-optimal. An increase in intimate partner violence (IPV) cases was linked to enforcement of COVID-19 lockdowns and other preventive measures especially in informal settings of Kampala. We determined the association between adherence to COVID-19 preventive measures and intimate partner violence among women dwelling in informal settings in Kampala, Uganda. Between July and October 2020, we conducted a three-month prospective cohort study of 148 women living in informal settlements of Kampala during the COVID-19 lockdown and easing of restrictive measures. Participants were surveyed at baseline, at 3-weeks and 6-weeks (endline). The dependent variable was adherence to COVID-19 preventive measures (remained adherent vs poorly adherent) between baseline and endline surveys. This composite outcome variable was computed from implementing all four variables: social distancing, wearing face masks, frequent hand washing and use of hand sanitizers at baseline and endline surveys. The key independent variable was IPV measured as experiencing at least one form of physical, emotional, or sexual IPV. Covariates were age, education, marital status, household size, occupation, and having problems getting food. Adjusted logistic regression analyses tested the independent association between adherence to COVID-19 preventive measures and intimate partner violence. Among 148 respondents, the mean age (SD) was 32.9 (9.3) years, 58.1% were exposed to at least one form of IPV, and 78.2% had problems getting food. Overall, 10.1% were poorly adherent to COVID-19 preventive measures during the first COVID-19 wave. After controlling for potential confounders, remaining adherent to COVID-19 preventive measures were more likely to experience intimate partner violence when compared to women who were poorly adherent to COVID-19 preventive measures during the first COVID-19 wave in Uganda [OR 3.87 95%CI (1.09, 13.79)]. Proportions of women in informal settlements of Kampala experiencing at least one form of IPV during the first COVID-19 wave is substantial. Remaining adherent to preventive measures for COVID-19 transmission may increase IPV exposure risk among women living in informal settlements in Kampala. Contextualizing COVID-19 interventions to the needs of marginalized and vulnerable women and girls in informal settings of Kampala is warranted. Processes to integrated violence prevention and response strategies into the Uganda COVID-19 prevention strategy are underscored.

Lived experiences of Ugandan women who had recovered from a clinical diagnosis of postpartum depression: a phenomenological study

BACKGROUND

Postpartum depression affects a significant proportion of women of childbearing age. The birth of a newborn baby is normally considered a joyful event, inhibiting mothers from expressing their depressive feelings. If the condition is not well understood and managed, mothers with postpartum depression are likely to experience suicidal ideation or even commit suicide. This study explored lived experiences of women who had recovered from a clinical diagnosis of postpartum depression in southwestern Uganda.

METHODS

This phenomenological study adopted the explorative approach through in-depth interviews as guided by the biopsychosocial model of depression. It was conducted in Mbarara Regional Referral Hospital, Bwizibwera Health Centre IV and Kinoni Health Centre IV located in Mbarara and Rwampara districts, southwestern Uganda. Data were collected from 30 postpartum mothers who were purposively selected, between 9th December 2019 and 25th September 2020. We analyzed this work using thematic data analysis and this was steered by the Colaizzi's six-step phenomenological approach of inquiry.

RESULTS

The findings were summarized into five major themes: 1) somatic experiences including insomnia and headache, breast pain, poor breast milk production, weight loss and lack of energy; 2) difficulties in home and family life including overwhelming domestic chores, lack of social support from other family members, fighting at home and financial constraints due to COVID-19 pandemic; 3) negative emotions including anger, self-blame, despondency and feelings of loneliness and regrets of conceiving or marriage; 4) feelings of suicide, homicide and self-harm including suicidal ideation and attempt, homicidal ideations and attempt and feelings of self-harm and 5) coping with postpartum depression including spirituality, termination of or attempt to leave their marital relationships, acceptance, counselling and seeking medical treatment, perseverance.

CONCLUSION AND RECOMMENDATIONS

Suicidal and homicidal thoughts are important parts of the postpartum depression experience, and these may put the lives of the mothers, their spouses and their babies at a great risk. Poor relationship quality, intimate partner violence and lack of financial resources contribute significantly to the negative emotional experiences of mothers with PPD.

Intimate partner violence as a predictor of antenatal care services utilization in Rwanda

Background

Although compelling evidence shows that exposure to intimate partner violence (IPV) during pregnancy is detrimental to both physical and mental health of the victims and their fetuses, studies on negative impact of IPV on antenatal care (ANC) services utilization are scarce.

Methods

The aim of the current study was to determine the impact of IPV exposure on ANC services utilization indicators such as (i) initiation of care within the first 3 months of pregnancy, (ii) receipt of at least four ANC visits and (iii) receipt of care from skilled providers among reproductive age women in Rwanda. This study used the data from the 2014–15 Rwanda Demographic and Health Survey. Multiple logistic regression was used to estimate the effects of physical and sexual IPV on the ANC services utilization indicators.

Results

Among married women living with their partners with at least one child aged 5 years or under (N = 5116), 17% of them reported physical violence, 22.8% reported psychological violence and 9.2% reported sexual violence. We found that there was a significant negative relationship between physical IPV and both early ANC and sufficient ANC. Women who had experienced physical violence by their partners during the preceding 12 months were less likely to receive more than four ANC visits, (O.R = 0.61, CI = 0.417–0.908) and they were less likely to attend the first ANC visits within the first 3 months (O.R = 0.656, CI = 0.445–0.967).

Conclusion

In this study, the prevalence of IPV still remains high and there is evidence that it does have significant impact on ANC. Therefore, the results provide support for continued efforts to reduce intimate partner violence, through the improvement of screening for IPV during ANC visits.

Is cohabitation as a form of union formation a licence to intimate partner physical violence in Uganda?

The study examined the argument that cohabitation as a form of union increases physical violence victimization among women. The study's aim was to assess the association between physical violence and other socio-demographic factors that influence physical violence among women. Self-reported data were extracted from the 2016 Uganda Demographic and Health Survey (UDHS), with a sample of 2479 couples, from the couple file. Chi-squared tests and multivariate Firth-logit regression models were used to examine the relationship between intimate partner violence (IPV) victimization and marital status controlling for other social-demographic factors. There was no significant evidence that women in cohabiting union have a higher risk of exposure to physical violence in the Ugandan context. The risk of experiencing physical violence perpetration varied by birth cohort, with the most recent cohorts exhibiting a slightly higher risk of experiencing partner violence than previous cohorts. Significant factors found to be associated with an increased risk of experiencing IPV included being in the poorer, middle and richer compared with the poorest wealth tertile of income, residing in Eastern or Northern regions compared with the Central region, being affiliated to the Catholic faith compared with Anglican and having five or more children compared with 4 or fewer children. In conclusion, there is no evidence that physical violence is more pronounced among women in cohabiting unions compared with married women in Uganda.

Intimate partner violence as a predictor of marital disruption in sub-Saharan Africa: A multilevel analysis of demographic and health surveys

Introduction

Intimate partner violence has gained momentum as health, social, and human right issue across the globe. Women within sub-Saharan Africa often do not report any case of violence due to the acceptance of violence which is rooted in their socio-cultural beliefs and practices. With a high prevalence of marital disruption in sub-Saharan Africa, it is important that we understand the role intimate partner violence plays in this phenomenon. Hence, this present study assessed the association between intimate partner violence and marital disruption among women in sub-Saharan Africa.

Methods

This study involved a cross-sectional analysis of data from the Demographic and Health Survey of 25 countries in sub-Saharan Africa. Multilevel binary logistic regression analysis was carried out and the results were presented as adjusted odds ratios (aOR) at 95% Confidence Interval (CI).

Results

The prevalence of physical, emotional, and sexual violence in the 25 countries considered in this study were 29.3%, 28%, and 11.5%, respectively. The highest prevalence of physical violence was in Sierra Leone (50.0%) and the lowest prevalence was in Comoros (5.7%). For emotional violence, the highest prevalence was in Sierra Leone (45.9%) and the lowest prevalence was in Comoros (7.9%). The highest prevalence of sexual violence was in Burundi (25.5%) and the lowest prevalence was in Comoros (1.8%). The average prevalence of marital disruption was 7.7%. This ranged from 1.3% in Burkina Faso to 20.2% in Mozambique. We found that women who had ever experienced physical violence were more likely to experience marital disruptions compared to those who had never experienced physical violence [aOR = 1.42, 95% CI = 1.35–1.50]. Women who had ever experienced sexual violence were more likely to experience marital disruption compared to those who had never experienced sexual violence [aOR = 1.29, 95% CI = 1.21–1.37]. Finally, women who had ever experienced emotional violence were more likely to experience marital disruption compared to those who had never experienced emotional violence [aOR = 1.86, 95% CI = 1.76–1.96].

Conclusion

Findings from this study call for proven effective intimate partner violence reduction interventions such as strengthening laws against intimate partner violence in sub-Saharan Africa. Again, marital counseling and health education interventions should be implemented to address the role of intimate partner violence on the wellbeing of women and the stability of couples in sub-Saharan Africa.

•

Intimate Partner Violence is the most common form, which involves all sexual, emotional, or physical harms as well as controlling behaviors aggravated by a current or former partner.

•

Intimate partner violence is associated with marital disruptions among women in sub-Saharan Africa.

•

Effective intimate partner violence reduction interventions should be be implemented to target women who are in violent relationships.

EVANGELICALISM IN UGANDA: IMPLICATIONS FOR PUBLIC HEALTH AND BIOETHICS

Considered attention is needed to the interplay between evangelical and charismatic religions and legislation in Uganda and their implications for public health, bioethics, and medical education. This manuscript examines the growth of the evangelical and charismatic movements in Uganda during the past several decades, concurrent trends in the formulation and implementation of law and public policy, and implications for the prevention and treatment of sexually transmitted infections, family violence, physician-patient communication, and medical and health education. The article concludes with suggested strategies to address the adverse consequences stemming from the interjection of religious perspectives into the domains of public health, clinical care, and health education.

Polygyny and intimate partner violence in sub-Saharan Africa: Evidence from 16 cross-sectional demographic and health surveys

In sub-Saharan Africa, where intimate partner violence has been found to be predominant, several scholars have made efforts to understand its predictors. Socio-culturally, polygyny has been considered as a key determinant of intimate partner violence. This study aimed to examine the association between polygyny and intimate partner violence in 16 sub-Saharan African countries. Binary logistic regression models were used in testing the association and the results were presented as crude and adjusted odds ratios at 95% confidence interval. The proportion of women in polygamous marriages in the 16 countries was 20.2%, ranging from as high as 40% in Chad to as low as 1.6% in South Africa. The prevalence of IPV was 30.7% in the 16 countries, ranging from as high as 44% in Uganda to as low as 12.7% in South Africa. The odds of IPV were higher among women in polygamous marriages in Angola, Burundi, Ethiopia, Uganda, Malawi, Mozambique, Zambia and Zimbabwe but was lower among women in polygamous marriages in Cameroon [COR = 0.54, 95% CI = 0.44-0.66] and Nigeria [COR = 0.61, 95% CI = 0.55-0.67], and this persisted after controlling for level of education, place of residence, wealth quintile, media exposure, and justification of violence. This study has found a significant association between polygyny and intimate partner violence. The practice of intimate partner violence in sub-Saharan Africa is fused into the socio-cultural norms and religious traditions of most countries in the sub-Saharan African region. The findings imply that family structures expose women to intimate partner violence. Therefore, global efforts in dealing with intimate partner violence through the Sustainable Development Goals should be done with attention on the socio-cultural norms and traditions around marriage and family structures.