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Ibrahim H, Goessmann K, Neuner F, Iffland B. Continuous chains: childhood maltreatment and intimate partner violence victimization among displaced women in a war context. BMC Womens Health 2024; 24:319. [PMID: 38824574 PMCID: PMC11143579 DOI: 10.1186/s12905-024-03156-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/24/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Childhood victimization has been associated with long-term psychological effects and an increased risk of being victimized in later life. Previous research has primarily focused on sexual abuse during childhood, and a wide range of consequences have been identified. However, a significant gap remains in our understanding of the complex interaction between different forms of childhood abuse and violence in later life, particularly in the context of broader social stressors such as armed conflict and displacement. METHODS This study examines the association between exposure to different types of childhood maltreatment in the context of family and intimate partner violence (IPV) among displaced women living in refugee camps in northern Iraq. Structured interviews were conducted by trained female psychologists with 332 women aged between 20 and 62 years. RESULTS Results indicated that over one-third of the participating women reported experiencing at least one occurrence of IPV by their husbands within the past year. In addition, participants reported experiences of different types of maltreatment (physical, emotional, and sexual violence and physical and emotional neglect) perpetrated by family members in their childhood. While all forms of childhood maltreatment showed an association with IPV within the past year, only emotional childhood maltreatment was found to be a significant predictor of IPV in a multivariate analysis. CONCLUSION The study highlights the ongoing impact of child maltreatment and its contribution to increased vulnerability to IPV victimization in later life. In addition, this study describes the specific cultural and contextual elements that contribute to IPV in refugee camps.
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Affiliation(s)
- Hawkar Ibrahim
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany.
- vivo international e.V., Konstanz, Germany.
| | - Katharina Goessmann
- Department of Clinical Psychology and Violence Research, Bielefeld University, Bielefeld, Germany
| | - Frank Neuner
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
- vivo international e.V., Konstanz, Germany
| | - Benjamin Iffland
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
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Odimegwu C, Phiri M, Tapera T, Simona S. Patterns and correlates of intention to use contraceptives among fecund sexually active women in developing countries. Glob Health Action 2023; 16:2255043. [PMID: 37681979 PMCID: PMC10494735 DOI: 10.1080/16549716.2023.2255043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/26/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Understanding a woman's future contraceptive needs and enhancing her chances of putting those needs into action depend heavily on her intentions to use contraceptive methods. However, there is little information about global perspectives of intention to utilise contraceptives among fecund sexually active women. OBJECTIVES This study examines the patterns and determinants of contraception intention of fecund sexually active women. METHODS The most recent Demographic and Health Surveys (DHS) from 59 countries were used for secondary data analysis. The DHSs applied a cross-sectional survey design to collect data from women between the ages of 15 and 49. The study comprises a sample of 697,590 fecund sexually active women in the reproductive ages. The desire to utilise contraceptive methods was examined using a multivariable binary logistic regression analysis. All analyses were weighted to allow for a complex survey design. RESULTS A pooled prevalence of intention to utilise contraception was 42.8% (95% CI: 42.5, 43.1) at the global level. Eastern and Southern Europe had the lowest prevalence, 17.3% (95% CI: 16.4, 18.2), and the highest prevalence was observed in countries from Latin America and the Caribbean, 68.0% (95% CI: 67.5, 69.9). Attaining secondary-level education (adjusted odds ratio (aOR) = 1.68; 95% CI: 1.62-1.72) or higher (aOR = 1.71; 95% CI: 1.63-1.80), working (aOR = 1.21; 95% CI: 1.18-1.24), experience of a pregnancy loss (aOR = 1.06; 95% CI: 1.03-1.09), or being exposed to media family planning messages (aOR = 1.51; 95% CI: 1.48-1.55) were factors associated with an increased likelihood of intent to use contraceptives. CONCLUSIONS The study has established that contraceptive use intention was low in many developing countries. Education, age, employment status, fertility preference, and exposure to family planning messages influenced contraceptive use intention. Health policy-makers ought to consider these factors when designing sexual and reproductive health strategies in developing countries.
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Affiliation(s)
- Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Million Phiri
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Talent Tapera
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Simona Simona
- Department of Social Work and Sociology, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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Alawode OA, Bolarinwa OA, Hajjar JM, Chukwudeh SO, Yaya S. Is intimate partner violence vertically transmitted among women in sub-Saharan Africa? Evidence from demographic health surveys between 2010 and 2019. Int J Equity Health 2023; 22:262. [PMID: 38102618 PMCID: PMC10725031 DOI: 10.1186/s12939-023-02074-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/03/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Violence against women is a major human rights violation, and the continuous occurrence of this can have many implications for women's social and health outcomes. The experience of violence from an intimate partner could be more intriguing, especially if such women experienced their mother's intimate partner violence (IPV) issues. Thus, this study examined the vertical transmission of IPV among women in sub-Saharan Africa (SSA). METHODS A total of 97,542 eligible women were drawn from 27 countries in SSA using a retrospective secondary dataset from Demographic Health Surveys conducted between 2010 and 2019. Multivariable analysis was employed to determine the association between the vertical transmission of IPV from mother to daughter and the covariates associated with IPV in SSA at p < 0.05. RESULTS The results showed that 40% of the respondents had experienced lifetime IPV, whilst 25% of those women reported that their mothers experienced it in childhood in SSA. Country-specific variations showed the highest prevalence of IPV experienced in Sierra Leone (60%) and the lowest in Comoros (9%). Results from model 1 showed that women who reported that their mothers experienced IPV were found to be significantly more than two times more likely to have experienced any form of IPV compared to those whose mothers did not (aOR = 2.66; 95% CI: 2.59-2.74), after adjusting for cofounders in Model 2, the result still showed that women who reported that their mothers experienced IPV were found to be significantly more than two times more likely to have experienced any form of IPV compared to those whose mothers did not (aOR = 2.56; 95% CI: 2.48-2.63). On the other hand, women with higher-educated partners, women in rural areas, and those from female-headed households were less likely to experience IPV. CONCLUSION This study concluded that women whose mothers experienced IPV were more likely to have experienced IPV. Our study also identified that education, rural areas, and female-headed households were protective factors against experiencing IPV. To address the groups of women at higher risk for experiencing IPV, we recommend ensuring that girls complete their education to promote greater wealth and resources.
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Affiliation(s)
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health, York St John University, London, UK.
- Department of Demography and Population Studies, University of Witwatersrand, Johannesburg, South Africa.
| | - Julia Marie Hajjar
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Kuunibe N, Bountogo M, Ouermi L, Sié A, Bärnighausen T, Harling G. Effects of education and age on the experience of youth violence in a very low-resource setting: a fixed-effects analysis in rural Burkina Faso. BMJ Open 2023; 13:e071104. [PMID: 37852761 PMCID: PMC10603425 DOI: 10.1136/bmjopen-2022-071104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 08/31/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVE The study aimed to investigate the effects of education and age on the experience of youth violence in low-income and middle-income country settings. DESIGN Using a standardised questionnaire, our study collected two waves of longitudinal data on sociodemographics, health practices, health outcomes and risk factors. The panel fixed-effects ordinary least squares regression models were used for the analysis. SETTINGS The study was conducted in 59 villages and the town of Nouna with a population of about 100 000 individuals, 1 hospital and 13 primary health centres in Burkina Faso. PARTICIPANTS We interviewed 1644 adolescents in 2017 and 1291 respondents in 2018 who participated in both rounds. OUTCOME AND EXPOSURE MEASURES We examined the experience of physical attacks in the past 12 months and bullying in the past 30 days. Our exposures were completed years of age and educational attainment. RESULTS A substantial minority of respondents experienced violence in both waves (24.1% bullying and 12.2% physical attack), with males experiencing more violence. Bullying was positively associated with more education (β=0.12; 95% CI 0.02 to 0.22) and non-significantly with older age. Both effects were stronger in males than females, although the gender differences were not significant. Physical attacks fell with increasing age (β=-0.18; 95% CI -0.31 to -0.05) and this association was again stronger in males than females; education and physical attacks were not substantively associated. CONCLUSIONS Bullying and physical attacks are common for rural adolescent Burkinabe. The age patterns found suggest that, particularly for males, there is a need to target violence prevention at younger ages and bullying prevention at slightly older ones, particularly for those remaining in school. Nevertheless, a fuller understanding of the mechanisms behind our findings is needed to design effective interventions to protect youth in low-income settings from violence.
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Affiliation(s)
- Naasegnibe Kuunibe
- Department of Economics, Faculty of Social Science and Arts, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Ghana
| | - Mamadou Bountogo
- Centre de Recherche en Sante de Nouna, Nouna, Burkina Faso
- Université de Ouagadougou, Ouagadougou, Burkina Faso
| | | | - Ali Sié
- Centre de Recherche en Sante de Nouna, Nouna, Burkina Faso
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- Institute for Global Health, University College London, London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Guy Harling
- Institute for Global Health, University College London, London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
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Nabayinda J, Namirembe R, Kizito S, Nsubuga E, Nabunya P, Bahar OS, Magorokosho N, Kiyingi J, Nattabi J, Tozan Y, Mayo-Wilson LJ, Mwebembezi A, Witte SS, Ssewamala FM. Correlates of Intimate Partner Violence Among Young Women Engaged in Sex Work in Southern Uganda. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:10749-10770. [PMID: 37212371 PMCID: PMC10524718 DOI: 10.1177/08862605231175908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
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.
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Affiliation(s)
| | - Rashida Namirembe
- International Center for Child Health and Development (ICHAD), Masaka, Uganda
| | - Samuel Kizito
- Washington University in St. Louis Brown School, MO, USA
| | - Edward Nsubuga
- Washington University in St. Louis Brown School, MO, USA
| | | | | | | | - Joshua Kiyingi
- Washington University in St. Louis Brown School, MO, USA
| | | | | | | | | | - Susan S. Witte
- Columbia University School of Social Work, New York, NY, USA
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Tessema ZT, Gebrie WM, Tesema GA, Alemneh TS, Teshale AB, Yeshaw Y, Alem AZ, Ayalew HG, Liyew AM. Intimate partner violence and its associated factors among reproductive-age women in East Africa:-A generalized mixed effect robust poisson regression model. PLoS One 2023; 18:e0288917. [PMID: 37594977 PMCID: PMC10437948 DOI: 10.1371/journal.pone.0288917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 06/23/2023] [Indexed: 08/20/2023] Open
Abstract
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.
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Affiliation(s)
- Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Worku Misganaw Gebrie
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alemneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hiwotie Getaneh Ayalew
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Mayanja Y, Kamacooko O, Lunkuse JF, Kyegombe N, Ruzagira E. Prevalence, Perpetrators, and Factors Associated With Intimate Partner Violence Among Adolescents Living in Urban Slums of Kampala, Uganda. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8377-8399. [PMID: 36825721 DOI: 10.1177/08862605231155128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Intimate partner violence (IPV) poses a public health burden, yet few studies have assessed co-existence of physical, emotional, and sexual IPV among adolescents. We assessed recent IPV victimization and associated factors and described IPV patterns and perpetrators among young people from urban slums in Kampala, Uganda. We conducted a prospective cohort study among 14 to 19-year-old individuals enrolled from March 2019 to March 2020 and followed quarterly for 12 months. We collected data on socio-demographics, sexual behavior, and substance use through interviews. Recent IPV victimization was documented at all visits if a participant reported experiencing physical, emotional, and/or sexual IPV in the past 3 months. Baseline factors associated with recent IPV victimization were determined using multivariable logistic regression. We enrolled 490 adolescents (60.6% female) with median age 18 years (Interquartile range (IQR) 17-18 years), 91.0% had less than secondary level education. Females mainly engaged in sex work (17.5%) and selling fruits/snacks (9.1%) while males commonly earned from sale of metal scrap or plastic waste (28.5%), 41% reported ≥10 life-time sexual partners, 16.1% were high-risk alcohol drinkers and 34.9% used illicit drugs in the past 3 months. Overall, 27.8% reported recent IPV victimization (20.0% females) with emotional IPV being common (17.8%). At baseline, recent IPV victimization was associated with high-risk alcohol consumption (adjusted odds ratio [aOR] 2.57; 95% confidence interval [CI] [1.44, 4.58]), reported paid sex in the past 3 months (aOR 1.82; [1.02, 3.22]) and being separated (aOR 2.47; [1.29, 4.73]). Recent IPV victimization declined from baseline to month 9 and increased at month 12 visits which coincided with the COVID-19 pandemic. IPV victimization is high among young people living in urban slums with emotional IPV being prevalent. IPV interventions are needed and should also address excessive alcohol consumption.
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Affiliation(s)
- Yunia Mayanja
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI and LSHTM) Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, London, UK
| | - Onesmus Kamacooko
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI and LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Jane Frances Lunkuse
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI and LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Nambusi Kyegombe
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI and LSHTM) Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, London, UK
| | - Eugene Ruzagira
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI and LSHTM) Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, London, UK
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Phiri M, Namayawa S, Sianyeuka B, Sikanyiti P, Lemba M. Determinants of spousal physical violence against women in Zambia: a multilevel analysis. BMC Public Health 2023; 23:934. [PMID: 37221522 DOI: 10.1186/s12889-023-15927-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023] Open
Abstract
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.
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Affiliation(s)
- Million Phiri
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Sibongile Namayawa
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | | | | | - Musonda Lemba
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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9
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Kisaakye P, Kafuko A, Bukuluki P. Lifetime violence and suicidal ideation among young women (18-24 years) in Uganda: Results from a population-based survey. Front Glob Womens Health 2023; 4:1063846. [PMID: 37139174 PMCID: PMC10150090 DOI: 10.3389/fgwh.2023.1063846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/28/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Violence is a major global public health issue that threatens the physical and mental health of victims. Of particular concern is the increasing evidence which suggests that violence is strongly associated with suicidal behavior including ideation. Methods This study uses data from the 2015 Violence Against Children Survey (VACS). This study seeks to highlight the relationship between lifetime violence and suicidal ideation using a nationally representative sample of 1,795 young women (18-24 years) in Uganda. Results Results indicate that respondents who experienced lifetime sexual violence (aOR = 1.726; 95%CI = 1.304-2.287), physical violence (aOR = 1.930; 95%CI = 1.293-2.882) or emotional violence (aOR = 2.623; 95%CI = 1.988-3.459) were more likely to experience suicidal ideation. Respondents who were not married (aOR = 1.607; 95%CI = 1.040-2.484), not having too much trust with community members (aOR = 1.542; 95%CI = 1.024-2.320) or not having a close relationship with biological parents (aOR = 1.614; 95%CI = 1.230-2.119) were more likely to experience suicidal ideation. Respondents who did not engage in work in the past 12 months prior to the survey (aOR = 0.629; 95%CI = 0.433-0.913) were less likely to experience suicidal ideation. Conclusion The results can be used to inform policy and programming and for integration of mental health and psychosocial support in programming for prevention and response to violence against young women.
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Affiliation(s)
- Peter Kisaakye
- Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Agatha Kafuko
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Paul Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
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10
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Richmond RL, Lee WH, Lin S, Obol JH, Akera P, Menezes G, Hyslop F, Awor A, Sevenska MS, Ojara P, Melik AG, Oceng D, Acaye L, Ayero P, Ayeerwot R, Dandgaval R, Bence E, Black E, Clarke S, Fry H, Worth H. Comparing Factors Associated With Intimate Partner Violence Among Rural and Urban Women in Northern Uganda. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5139-5163. [PMID: 36065598 DOI: 10.1177/08862605221120902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Intimate partner violence (IPV) is an important public health issue with negative effects at individual and societal levels. In northern Uganda, IPV prevalence is high but literature on it is limited. Northern Uganda has a long history of socio-economic and political upheavals, which are recognized risk factors for IPV. We compare IPV prevalence among rural and urban women in northern Uganda. This was a cross-sectional survey of 856 northern Ugandan women, 409 women living in rural areas, and 447 women working in an urban marketplace. Data were analyzed using logistic regression. High rates of emotional, physical, and sexual IPV were found. Almost four of five participants had experienced at least one type of IPV during their lifetime, and approximately half of the participants had experienced IPV in the 12 months prior to the survey. Many women stated that IPV was justified in certain situations. Younger age was a significant determinant of IPV in both cohorts (adjusted odds ratio [aOR] 0.95, 95% confidence interval [CI] [0.93-0.97]). Determinants of IPV among the rural cohort included male partner's alcohol abuse (aOR 2.22, CI [1.34-3.73]); having been in a physical fight with another man (aOR 1.90, 95% CI [1.12-3.23]); and controlling behaviors (aOR 1.21, CI [1.08-1.36]). Possible protective factors in the urban cohort included markers of economic empowerment such as being the decision maker on large household items (59.2% vs. 44.6%, p = .002) and having a mobile phone (20.4% vs. 12.4%, p = .024). Our study shows that IPV is a significant issue in northern Uganda. Economic empowerment is associated with lower rates of IPV in urban women, and interventions to reduce gender wealth inequality may reduce IPV prevalence. Further studies on enablers of IPV and the effect of conflict on IPV prevalence are needed to inform future interventions.
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Affiliation(s)
| | - Wei Hao Lee
- University of New South Wales, Sydney, Australia
| | - Sophia Lin
- University of New South Wales, Sydney, Australia
| | - James Henry Obol
- University of New South Wales, Sydney, Australia
- Gulu University, Uganda
| | - Peter Akera
- University of New South Wales, Sydney, Australia
- Gulu University, Uganda
| | - Gail Menezes
- University of New South Wales, Sydney, Australia
| | - Fran Hyslop
- University of New South Wales, Sydney, Australia
| | | | | | | | | | | | | | | | | | | | - Emma Bence
- University of New South Wales, Sydney, Australia
| | | | - Susan Clarke
- University of New South Wales, Sydney, Australia
| | - Helen Fry
- University of New South Wales, Sydney, Australia
| | - Heather Worth
- University of New South Wales, Sydney, Australia
- University of the South Pacific, Rarotonga, Cook Islands
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Ogunbiyi BO, Maclin BJ, Bingenheimer JB, Vyas A. Comparing Changes in IPV Risk by Age Group over Time in Conflict-Affected Northeast Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1878. [PMID: 36767243 PMCID: PMC9915075 DOI: 10.3390/ijerph20031878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/06/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Increased risk of intimate partner violence (IPV) has been well documented among women and girls living in conflict zones. However, how residence in a conflict area differentially impacts adolescent girls and young women (AGYW) compared to older women is less understood. This paper examines whether the levels of IPV changed more among AGYW compared to older women in six Boko Haram (BH)-affected States in Nigeria. The Nigeria Demographic and Health Survey data was used to compare the level of the three types of IPV (emotional, physical, and sexual) among AGYW compared to older women before and during the BH conflict (2008 and 2018). We ran a multiple linear regression model with an interaction term for ever-partnered female respondents living in six Northeast States, adjusting for relevant covariates. A significantly higher proportion of both older and younger women reported experiencing emotional and sexual IPV in 2018 than in 2008, with a higher increase reported among AGYW. Sexual IPV increased by six percentage points more among AGYW compared to older women. AGYW in the BH-affected States are more vulnerable to experiencing sexual IPV relative to older women. This study highlights the need for youth-focused IPV interventions in the BH-affected States.
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12
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Gupta J, Kanselaar S, Zhang C, Zaidi J. Disability and intimate partner violence in fragile states: A multi-country analysis. Glob Public Health 2023; 18:2204339. [PMID: 37114452 DOI: 10.1080/17441692.2023.2204339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The 2030 Sustainable Development Goals call for both the elimination of violence against women and girls and disability-disaggregated data. However, few population-based, multi-country studies have examined how disability impacts intimate partner violence (IPV) in fragile settings. Demographic and Health Survey data from five countries (Pakistan, Timor-Leste, Mali, Uganda, and Haiti) were pooled and analyzed to assess the relationship between disability and IPV (N = 22,984). Pooled analysis revealed an overall disability prevalence of 18.45%, with 42.35% lifetime IPV (physical, sexual and/or emotional), and 31.43% past-year IPV. Women with disabilities reported higher levels of past-year and lifetime IPV compared to those without disabilities (AOR 1.18; 95% CI 1.07, 1.30; AOR 1.31; 95% CI 1.19, 1.44, respectively). Women and girls with disabilities may be disproportionately impacted by IPV in fragile settings. More global attention is needed to address IPV and disability in these settings.
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Affiliation(s)
- Jhumka Gupta
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Samantha Kanselaar
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Cheyu Zhang
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Jaffer Zaidi
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
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Lyons MJ, Swahn MH, Culbreth R, Reidy D, Musuya T, Bukuluki P. A Comparative Analysis of Gender Discrepancy Stress, Attitudes toward Intimate Partner Violence, and Perpetration among Young Adults in the USA and Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13373. [PMID: 36293954 PMCID: PMC9602678 DOI: 10.3390/ijerph192013373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is a dearth of data on the modifiable factors that contribute to violence in low- and middle-income countries, including attitudes regarding intimate partner violence (IPV) and perceptions of gender identity. We examined these factors using a cross-cultural comparison between young adults in Uganda and the United States. METHODS A cross-sectional survey was distributed to young adults aged 18 to 25 in Uganda (n = 300) and the U.S. (n = 300). Survey questions assessed demographics, attitudes toward IPV, IPV victimization and perpetration, gender discrepancy, discrepancy stress, and alcohol use. We conducted chi-square tests, as well as bivariable and multivariable logistic regression analyses, separately for participants in each country. RESULTS The prevalence of IPV perpetration differed significantly by country for men (58.06% in the U.S. vs. 42.73% in Uganda; p = 0.03) and women (40.00% in the U.S. vs. 14.00% in Uganda; p < 0.01). IPV victimization differed by country for men (67.74% in the U.S. vs. 51.82% in Uganda; p = 0.02) but not for women. Gender discrepancy and discrepancy stress also varied by country and by sex and were higher in the U.S. for both men and women. IPV victimization was a common risk factor for adults in both Uganda (Adj. OR = 23.47; 95% CI: 7.79, 70.22) and the U.S. (Adj. OR = 27.40; 95% CI: 9.97, 75.32). In Uganda, male sex was significantly associated with IPV perpetration in multivariable analyses (Adj. OR = 6.23; 95% CI: 2.45, 15.86), and so were IPV attitudes (Adj. OR = 2.22; 1.20, 4.10). In the U.S., a likely alcohol use disorder (AUD) was also significantly associated with IPV perpetration (Adj. OR = 7.11; 95% CI: 2.25, 22.54). CONCLUSIONS Permissive IPV attitudes were associated with IPV perpetration among Ugandan participants, while likely AUD was associated with perpetration in U.S. PARTICIPANTS Overall, IPV perpetration was significantly higher for U.S. males compared with Ugandan males. These findings indicate that cultural adaptations to global IPV interventions may be necessary to respond to differing needs in different countries.
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Affiliation(s)
- Matthew J. Lyons
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA
| | - Monica H. Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA
| | - Rachel Culbreth
- American College of Medical Toxicology, Phoenix, AZ 85028, USA
| | - Dennis Reidy
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Tina Musuya
- Social Development Direct, Kampala 759125, Uganda
| | - Paul Bukuluki
- Department of Social Work and Social Administration, Makerere University, Kampala 759125, Uganda
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Ahinkorah BO, Onayemi OM, Seidu AA, Awopegba OE, Ajayi AI. Association Between Girl-child Marriage and Intimate Partner Violence in Sub-Saharan Africa: Insights From a Multicountry Analysis of Demographic and Health Surveys. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP13560-NP13580. [PMID: 33832374 DOI: 10.1177/08862605211005139] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
While considerable attention has been given to the health consequences of child marriage in Sub-Saharan Africa (SSA), limited studies exist on its impact on intimate partner violence (IPV) in the region. We address this gap by examining the link between child marriage and IPV. We tested our study hypothesis using demographic and health survey data of 28,206 young women aged 20-24 years from 16 SSA countries with recent surveys (2015-2019). Binary logistic regression models were used to examine the effect of child marriage on IPV. Child marriage prevalence ranged from 13.5% in Rwanda, in East Africa, to 77% in Chad, in Central Africa, while IPV ranged from 17.5% in Mozambique in Southern Africa to 42% in Uganda, in East Africa. Past year experience of IPV was higher among young women who married or begun cohabiting before the age of 18 (36.9%) than those who did at age 18 or more (32.5%). This result was consistent for all forms of violence: physical violence (22.7% vs 19.7%), emotional violence (25.3% vs 21.9%), and sexual violence (12% vs 10.4%). After controlling for covariates, we found that young women in SSA who married before 18 years were more likely to experience IPV than those who married as adults (AOR: 1.20; 95% CI [1.12, 1.29]). Significant heterogeneity was observed in the country-level results, with a higher likelihood of IPV found in 14 of the 16 countries and lower in Angola and Chad. Child marriage is associated with a higher likelihood of IPV in most SSA countries, suggesting that ending child marriage will result in a substantial reduction in IPV. There is a need to institute policies to support and protect women who marry as children from abusive relationships in SSA.
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Affiliation(s)
| | | | - Abdul-Aziz Seidu
- University of Cape Coast, Ghana
- James Cook University, Townsville, Queensland, Australia
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15
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Islam MM, Khan MN, Rahman MM. Intimate Partner Abuse Among Rohingya Women and Its Relationship With Their Abilities to Reject Husbands' Advances to Unwanted Sex. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11315-NP11332. [PMID: 33546563 DOI: 10.1177/0886260521991299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Currently, around a million Rohingya refugees live in Cox's Bazar, Bangladesh. Displacement from homelands and restrictions on movement in the refugee camps may exacerbate intimate partner abuse (IPA) against refugee women and their abilities to reject husbands' advances to unwanted sex. This study examines Rohingya refugee women's attitudes toward and experience of intimate partner abuse (IPA) and their impact on the abilities to reject husbands' advances to unwanted sex. A survey was conducted among Rohingya refugee women in Cox's Bazar, Bangladesh. Women's attitudes toward IPA, and experience of IPA were the exposure variables. Women's abilities to say "no" to husbands' advances to unwanted sexual intercourse was the outcome variable. Multivariable logistic regression models were used to examine the relationships. Participants' median age was 22 years (range: 13-41). Most women perceived hitting/beatings by their husbands in certain situations as justifiable, 72% had experienced such abuse and 56.5% had to engage in unwanted sexual intercourse with their husbands. Women with increasing leniency towards hitting/beatings and those who had experienced such abuse were less likely to be able to say "no" to husbands' advances to unwanted sexual intercourse. Rohingya women's attitudes toward and experience of IPA are associated with their abilities to say "no" to husbands' advances to unwanted sex. Intervention is needed to denormalize the current practice of IPA, create awareness against IPA, and ensure formal education for girls.
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Tadesse AW, Tarekegn SM, Wagaw GB, Muluneh MD, Kassa AM. Prevalence and Associated Factors of Intimate Partner Violence Among Married Women During COVID-19 Pandemic Restrictions: A Community-Based Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP8632-NP8650. [PMID: 33289437 PMCID: PMC9160437 DOI: 10.1177/0886260520976222] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Ethiopia has taken unprecedented preventive measures, such as confinement to home and closure of schools and offices to halt the spread of Corona virus pandemic in the country. Unfortunately, such orders may have been associated with intimate partner violence (IPV) against women but there is no study conducted to assess the magnitude of IPV during the lock-downs in the country. Thus, this study intended to investigate the prevalence and associated factors of IPV against women during the COVID-19 pandemic restrictions. A community-based cross-sectional study was conducted on sample of 617 married or cohabited women. A systematic random sampling technique was employed to identify and enroll women who are married. A logistic regression analysis was used to identify the predictors of IPV among women and all statistical analyses were carried out using STATA 14.2. In this study, amongst the 589 married women who were included in the analysis, 22.4% [95% CI: 19.1%, 25.9%] were experienced at least one form of IPV. Additionally, 11.0%, 20.0%, and 13.8% of women also experienced physical, psychological, and sexual IPVs respectively. After adjusting for covariate; being illiterate [AOR=2.37: 95% CI 1.29, 4.35], having illiterate husband [AOR=2.67: 95% CI 1.36, 5.21], having substance user husband (alcohol, chat or cigarettes) [AOR=2.75: 95% CI 1.42, 5.34], and community tolerant attitude to violence [AOR=2.97: 95% CI 1.17, 7.61] were the independent predictors of IPV amongst married women. In conclusion, the prevalence of IPV among married women was comparable to the national pre-COVID figure of IPV. Therefore, national and regional governments should work toward enhancing gender equality, coupled with addressing risk factors at multiple levels, using community- and institution-based approaches to prevent IPV and to specifically achieve SDG5 of eliminating violence against women by 2030.
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Affiliation(s)
- Abay Woday Tadesse
- Samara University, Samara, Ethiopia
- Dream Science and Technology College, Dessie, Ethiopia
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17
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Yalçın SU, Özaslan ZZ, Dinç S, Bilgin H. AN EXAMINATION OF EFFECTS OF INTIMATE PARTNER VIOLENCE ON CHİLDREN: A CROSS-SECTIONAL STUDY CONDUCTED IN PEDIATRIC EMERGENCY UNIT IN TURKEY. J Nurs Manag 2022; 30:1648-1657. [PMID: 35560694 DOI: 10.1111/jonm.13673] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/24/2022] [Accepted: 05/09/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Intimate Partner Violence (IPV) against women causes inadequate and unbalanced nutrition in children aged 0-5 years and adversely affects their growth. AIM To examine the impact of intimate partner violence on a child's growth regarding the medical diagnosis in paediatric patients under 5-year-old, growth of the child, and mother's exposure to intimate partner violence. METHODS This descriptive cross-sectional study included 166 children, admitted to the paediatric emergency department, and their mothers. RESULTS Women exposed to emotional violence and controlling behaviour during pregnancy had children prone to being overweight and obese. Mothers' lifetime exposure to physical violence had an adverse effect on their children's wasting and moderate wasting. In contrast, mothers' exposure to emotional violence had a direct impact on childs' wasting and moderate wasting. CONCLUSION The lifetime effect of domestic violence may begin at birth. This vulnerability leads to negative outcomes in both children and women regarding biopsychosocial development. Implications for nursing management Nurses and midwives in primary healthcare services and one-on-one care should be trained to evaluate prospective mothers and children aged 0-5 regarding violence and its effects on the child's growth.
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Affiliation(s)
- Suna Uysal Yalçın
- Kocaeli Health and Technology University, Psychiatric and Mental Health Nursing Department, Kocaeli, Turkey
| | - Zeynep Zonp Özaslan
- University of Michigan, School of Nursing, Ann Arbor, USA;Kocaeli University, Psychiatric and Mental Health Nursing Department, Kocaeli, Turkey
| | - Sermin Dinç
- Istanbul University-Cerrahpaşa Florence Nightingale Faculty of Nursing, Child Health and Diseases Nursing, İstanbul, Turkey
| | - Hülya Bilgin
- Istanbul University-Cerrahpaşa Florence Nightingale Faculty of Nursing, Psychiatric and Mental Health Nursing Department, İstanbul, Turkey
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Aboagye RG, Dadzie LK, Arthur-Holmes F, Okyere J, Agbaglo E, Ahinkorah BO, Seidu AA. Intimate partner violence against married and cohabiting women in sub-Saharan Africa: does sexual autonomy matter? Reprod Health 2022; 19:79. [PMID: 35346246 PMCID: PMC8962047 DOI: 10.1186/s12978-022-01382-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/11/2022] [Indexed: 11/15/2022] Open
Abstract
Background Literature shows that women’s sexual autonomy, which refers to women’s capacity to refuse sex and ask a partner to use condom, has significant implications on the sexual and reproductive health outcomes and sexual-and-gender based violence. Nevertheless, there is scarcity of empirical evidence to support the association between women’s sexual autonomy and intimate partner violence (IPV) in sub-Saharan Africa. Methods Data for the study were extracted from the recent Demographic and Health Surveys in 24 countries in sub-Saharan Africa between 2010 and 2019. Bivariable and multivariable binary logistic regression analyses were performed to examine the association between sexual autonomy and IPV in all the studied countries. Statistical significance was set at p < 0.05. Results The pooled prevalence of IPV and sexual autonomy in the 24 countries were 38.5% and 73.0% respectively. Overall, the odds of exposure to IPV were higher among women with sexual autonomy, compared to those without sexual autonomy even after controlling for covariates (age, level of education, marital status, current working status, place of residence, wealth quintile and media exposure). At the country-level, women from Angola, Cameroon, Chad, Gabon, Cote d’lvoire, Gambia, Mali, Nigeria, Kenya, Comoros, Zambia, and South Africa who had sexual autonomy were more likely to experience IPV whilst those in Burundi were less likely to experience IPV. The study showed that sexual autonomy increases women’s exposure to IPV and this occurred in many countries except Burundi where women with sexual autonomy were less likely to experience IPV. Conclusion The findings highlight the need for serious programs and policies to fight against IPV in the sub-region. Additionally, laws need to be passed and implemented, with law enforcement agencies provided with the necessary resources to reduce intimate partner violence among women with sexual autonomy. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-022-01382-1. Globally, intimate partner violence is regarded as a public health concern due to its devastating effects on the physical, emotional, and reproductive health of women. This study sought to determine how women’s capacity to refuse sex, negotiate for safe sex practices such as insisting on partner to use condom, and feeling justified in asking a partner to use condom is associated with the potential of experiencing violence from an intimate partner. Using data from the demographic and health survey conducted between 2010 and 2019, we found that women who had more capacity to refuse sex, negotiate for safe sex practices such as insisting on partner to use condom, and feeling justified in asking a partner to use condom were more likely to experience violence from their intimate partners after controlling for other factors such as the age of the woman, level of education, marital status, place of residence, economic status, and media exposure. The results highlight the need for sub-Saharan African countries to step up programs that ease up intimate partner violence reporting and access to legal support for those who experience it. Additionally, laws need to be passed and implemented, with law enforcement agencies provided with the necessary resources to reduce intimate partner violence among women with sexual autonomy.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
| | - Louis Kobina Dadzie
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer Agbaglo
- Department of English, University of Cape Coast, Cape Coast, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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19
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Gubi D, Wandera SO. Prevalence and correlates of intimate partner violence among ever-married men in Uganda: a cross-sectional survey. BMC Public Health 2022; 22:535. [PMID: 35303848 PMCID: PMC8932289 DOI: 10.1186/s12889-022-12945-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/01/2022] [Indexed: 11/21/2022] Open
Abstract
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.
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Affiliation(s)
- Derrick Gubi
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda.
| | - Stephen Ojiambo Wandera
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda.,Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
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20
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Mannell J, Lowe H, Brown L, Mukerji R, Devakumar D, Gram L, Jansen HAFM, Minckas N, Osrin D, Prost A, Shannon G, Vyas S. Risk factors for violence against women in high-prevalence settings: a mixed-methods systematic review and meta-synthesis. BMJ Glob Health 2022; 7:e007704. [PMID: 35296455 PMCID: PMC8928330 DOI: 10.1136/bmjgh-2021-007704] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/08/2022] [Indexed: 12/11/2022] Open
Abstract
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).
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Affiliation(s)
| | - Hattie Lowe
- Institute for Global Health, UCL, London, UK
| | - Laura Brown
- Institute for Global Health, UCL, London, UK
| | | | | | - Lu Gram
- Institute for Global Health, UCL, London, UK
| | | | | | - David Osrin
- Institute for Global Health, UCL, London, UK
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21
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Cohen F, Seff I, Ssewamala F, Opobo T, Stark L. Intimate Partner Violence and Mental Health: Sex-Disaggregated Associations Among Adolescents and Young Adults in Uganda. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:2399-2415. [PMID: 32644032 PMCID: PMC7794091 DOI: 10.1177/0886260520938508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Experiences of intimate partner violence (IPV) victimization have well-established associations with poor mental health. There is also burgeoning evidence regarding the association between IPV perpetration and mental health in a small number of countries. However, there is a paucity of data about the gendered differences for these IPV experiences within sub-Saharan African. This study examines the association between IPV victimization, perpetration, and mental health outcomes for male and female adolescents and young adults in Uganda. Data on IPV perpetration were available for a nationally representative sample of 1,373 males and 2,022 females in Uganda. Observations were weighted to be representative of 13- to 24-year-olds in Uganda. Study procedures used multivariate logistic regression models to examine associations between ever-perpetration of IPV and four self-reported mental health variables: severe sadness, feelings of worthlessness, suicide ideation, and alcohol abuse. Models controlled for age, marital status, schooling, and past exposure to violence. Models were sex-disaggregated to examine sex-specific associations. Standard errors were adjusted for sampling stratification and clustering. Data analysis showed that males were more than twice as likely as females to perpetrate IPV (14% vs. 6%, respectively; p < .001), while odds of perpetration for both sexes were higher for those ever experiencing IPV (adjusted odds ratio [aOR] = 12.12 for males; aOR=4.73 for females). Male perpetrators had 2.93 greater odds of experiencing suicidal ideation (95% confidence interval [CI]: [1.78, 4.82], p < .001) and increased drinking behaviors (2.21, 95% CI: [1.39, 3.50], p < .001) when compared with non-perpetrating males. In addition, female perpetrators had 2.59 times greater odds of suicidal ideation (95% CI: [1.34,4.99], p < .01), as compared with non-perpetrating females. Our findings among youth and adolescents demonstrated associated but different experiences for males and females. Findings indicate the importance of understanding the relationship between IPV victimization and perpetration, and addressing these correlates with a gender-sensitive perspective to inform policy and programming.
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Affiliation(s)
| | - Ilana Seff
- Washington University in St. Louis, MO, USA
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Akombi-Inyang B, Ghimire PR, Archibong E, Woolley E, Razee H. Association between intimate partner violence and male alcohol use and the receipt of perinatal care: Evidence from Nepal demographic and health survey 2011-2016. PLoS One 2021; 16:e0259980. [PMID: 34874942 PMCID: PMC8651139 DOI: 10.1371/journal.pone.0259980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 10/29/2021] [Indexed: 11/29/2022] Open
Abstract
The utilization of perinatal care services among women experiencing intimate partner violence (IPV) and male alcohol use is a major problem. Adequate and regular perinatal care is essential through the continuum of pregnancy to mitigate pregnancy and birth complications. The aim of this study is to determine the association between IPV and male alcohol use and the receipt of perinatal care in Nepal. This study used pooled data from 2011 and 2016 Nepal Demographic and Health Surveys (NDHS). A total of 3067 women who interviewed for domestic violence module and had most recent live birth 5 years prior surveys were included in the analysis. Multivariable logistic regression analysis was performed to determine the association between IPV and male alcohol use and the receipt of perinatal care. Of the total women interviewed, 22% reported physical violence, 14% emotional violence, and 11% sexual violence. Women who were exposed to physical violence were significantly more likely to report non-usage of institutional delivery [adjusted Odds Ratio (aOR) = 1.30 (95% Cl: 1.01, 1.68)] and skilled delivery assistants [aOR = 1.43 (95% Cl: 1.10, 1.88)]. Non-attendance of 4 or more skilled antenatal care visits was associated with a combination of alcohol use by male partner and exposure to emotional [aOR = 1.42 (95% Cl: 1.01, 2.00)] and physical violence [aOR = 1.39 (95% Cl: 1.03, 1.88)]. The negative association between IPV and perinatal care suggests it is essential to develop comprehensive community-based interventions which integrates IPV support services with other health services to increase the uptake of perinatal care through the continuum of pregnancy.
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Affiliation(s)
- Blessing Akombi-Inyang
- School of Population Health, University of New South Wales, Sydney, Australia
- School of Health Sciences, Western Sydney University, Penrith, Australia
- * E-mail:
| | - Pramesh Raj Ghimire
- School of Health Sciences, Western Sydney University, Penrith, Australia
- Ujyalo Nepal, Ratnanagar Municipality, Nepal
| | | | - Emma Woolley
- School of Education, Macquarie University, Sydney, Australia
| | - Husna Razee
- School of Population Health, University of New South Wales, Sydney, Australia
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Bukuluki P, Kisaakye P, Wandiembe SP, Musuya T, Letiyo E, Bazira D. An examination of physical violence against women and its justification in development settings in Uganda. PLoS One 2021; 16:e0255281. [PMID: 34587182 PMCID: PMC8480831 DOI: 10.1371/journal.pone.0255281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/14/2021] [Indexed: 11/18/2022] Open
Abstract
This paper uses data from a community cross-sectional survey to examine the factors that are associated with justification of physical violence against women. Results indicate that respondents who were married at the time of the survey were less likely (OR = 0.29; CI = 0.17–0.52) to agree that it is justified for a man to physically assault his partner that their counterparts who were single. The likelihood to justify physical violence was less likely to happen among respondents with primary education (OR = 0.49; CI = 0.39–0.62), secondary education (OR = 0.40; CI = 0.31–0.53) and vocation or tertiary education (OR = 0.28; CI = 0.19–0.41) than among respondents with no education. Protestants were less likely (OR = 0.77; CI = 0.64–0.94) to justify physical violence than the Catholics. Respondents who were not formally employed were more likely (OR = 1.66; CI = 1.32–2.08) to justify physical violence than their counterparts who were in formal employment in the last three months preceding the survey. Respondents who agreed that it is okay for a man to control his partner’s movements (OR = 1.27; CI = 1.04–1.55), it is okay for a man to have sex with his wife anytime (OR = 2.28; CI = 1.87–2.78), alcohol is the main reason for violence against women (OR = 1.67; CI = 1.33–2.10), men need sex more than women (OR = 1.57; CI = 1.23–1.99) and women know where to obtain support in case of violence (OR = 1.42; CI = 1.00–2.02) were more likely to justify physical violence than respondents who disagreed. The likelihood to justify physical violence was less among respondents who agreed that: violence is not the only way to deal with disagreements (OR = 0.54; CI = 0.33–0.86), it is possible for men to stop violence (OR = 0.62; CI = 0.47–0.82) and it is acceptable for a woman to ask her partner to use a condom (OR = 0.61; CI = 0.51–0.73) than their counterparts who disagreed. There is need to increase investment in social norms change programmes in order to strengthen contestation of tolerance of physical violence among men and women in Uganda.
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Affiliation(s)
- Paul Bukuluki
- School of Social Sciences, Makerere University, Kampala, Uganda
- * E-mail:
| | - Peter Kisaakye
- School of Statistics and Planning, Makerere University, Kampala, Uganda
| | | | - Tina Musuya
- Centre for Domestic Violence Prevention, Mulago, Uganda
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Ouma S, Ndejjo R, Abbo C, Tumwesigye NM. Client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda: a cross-sectional study. BMJ Open 2021; 11:e046894. [PMID: 34518251 PMCID: PMC8438829 DOI: 10.1136/bmjopen-2020-046894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY OBJECTIVE To determine the prevalence and associated factors of client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda. DESIGN AND SETTINGS We conducted a cross-sectional study among female sex workers in Gulu district in conflict-affected Northern Uganda. PARTICIPANTS The study participants included 300 female sex workers aged 18+ years. The participants were selected using simple random sampling from a database of female sex workers maintained at a national non-governmental organisation in Gulu. OUTCOME MEASURE The outcome measure was self-reported exposure to client-perpetrated gender-based violence. METHODS We used a pretested semistructured questionnaire to collect data on sociodemographic characteristics, sex work-related characteristics, alcohol use, illicit drug use, HIV status and self-reported exposure to client-perpetrated gender-based violence. Then, data were entered into Epi Info V.7 and analysed using Stata V.14.0. RESULTS Among participants, 61.0% reported client-perpetrated gender-based violence. Economic (58.7%) and emotional (52.0%) violence were the most common forms of client-perpetrated gender-based violence in this population. Independently, being: street-based (adjusted OR=9.66, 95% CI 2.78 to 33.5), mobile (adjusted OR=3.21, 95% CI 1.83 to 5.64), HIV-positive (adjusted OR=1.90, 95% CI 1.09 to 3.31) and a low-income earner (<USh200 000 monthly) (adjusted OR=2.26, 95% CI 1.18 to 4.30) were positively associated with exposure to client-perpetrated gender-based violence. CONCLUSIONS There is a high prevalence of client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda. Furthermore, female sex workers who were street-based, mobile, HIV-positive and low-income earners were more likely to experience client-perpetrated gender-based violence. The ministry of health and the development partners need to provide targeted public health interventions to prevent and manage the rampant gender-based violence among this underserved population.
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Affiliation(s)
- Simple Ouma
- Research Department, The AIDS Support Organization, Kampala, Uganda
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Catherine Abbo
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nazarius M Tumwesigye
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
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Aboagye RG, Seidu AA, Asare BYA, Peprah P, Addo IY, Ahinkorah BO. Exposure to interparental violence and justification of intimate partner violence among women in sexual unions in sub-Saharan Africa. ACTA ACUST UNITED AC 2021; 79:162. [PMID: 34503582 PMCID: PMC8428140 DOI: 10.1186/s13690-021-00684-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/26/2021] [Indexed: 12/17/2022]
Abstract
Background Justification of intimate partner violence (IPV) is one of the critical factors that account for the high prevalence of IPV among women. In this study, we examined the association between exposure to interparental violence and IPV justification among women in sexual unions in sub-Saharan Africa (SSA). Methods Data for this study were obtained from the most recent Demographic and Health Surveys (DHS) of 26 countries in SSA conducted between 2010 and 2020. A total of 112,953 women in sexual unions were included in this study. A multivariable binary logistic regression analysis was carried out. The results of the regression analysis were presented using crude odds ratios (cOR) and adjusted odds ratios (aOR) with their respective 95% confidence intervals (CIs). Results The prevalence of interparental violence in the countries considered in this study was 23.8%, with the highest (40.8%) and lowest (4.9%) in Burundi and Comoros, respectively. IPV justification was 45.8%, with the highest and lowest prevalence in Mali (80.9%) and South Africa (4.6%) respectively. Women who were exposed to interparental violence were more likely to justify IPV compared to those who were not exposed [aOR = 1.53, 95% CI = 1.47–1.59]. We found higher odds of justification of IPV among women who were exposed to interparental violence compared to those who were not exposed in all the countries, except Burkina Faso, Comoros, Gambia, and Rwanda. Conclusion The findings call for several strategies for addressing interparental violence. These may include empowerment services targeting both men and women, formation of stronger social networks to improve women’s self-confidence, and the provision of evidence-based information and resources at the community level. These interventions should pay critical attention to young people exposed to interparental violence. Public health education and messaging should emphasise on the negative health and social implications of interparental violence and IPV.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana. .,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia. .,Department of Estate Management, Takoradi Technical University, P.O. Box, 257, Takoradi, Ghana.
| | - Bernard Yeboah-Asiamah Asare
- Curtin School of Population Health, Curtin University, Perth, Australia.,Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, Australia.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Isaac Yeboah Addo
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Hicks MHR, Mohsin M, Silove D, Fisher J, Moussa B, Steel Z, Nancarrow H, Nadar N, Klein L, Hasoun F, Yousif M, Khalil B, Krishna Y, Rees SJ. Attitudes towards gender roles and prevalence of intimate partner violence perpetrated against pregnant and postnatal women: Differences between women immigrants from conflict-affected countries and women born in Australia. PLoS One 2021; 16:e0255105. [PMID: 34329321 PMCID: PMC8323950 DOI: 10.1371/journal.pone.0255105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 07/09/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The aim was to compare, for the first time in a large systematic study, women born in conflict-affected countries who immigrated to Australia with women born in Australia for attitudes towards gender roles and men's use of IPV and the actual prevalence of IPV. The study also examined if any associations remained across the two timepoints of pregnancy and postpartum. METHODS Women were interviewed during their first visit to one of three Australian public hospital antenatal clinics and re-interviewed at home six months after giving birth. A total of 1111 women completed both interviews, 583 were born in conflict-affected countries and 528 born in Australia. Associations between attitudes towards gender roles and men's use of IPV, socio-demographic characteristics and reported actual experiences of IPV were examined using bivariate and multiple logistic regression analyses. RESULTS Attitudes toward inequitable gender roles including those that condone men's use of IPV, and prevalence of IPV, were significantly higher (p<0.001) among women born in conflict-affected countries compared to Australia-born women. Women born in conflict-affected countries with the strongest held attitudes towards gender roles and men's use of IPV had an adjusted odds ratio (aOR) of 3.18 for IPV at baseline (95% CI 1.85-5.47) and an aOR of 1.83 for IPV at follow-up (95% CI 1.11-3.01). Women born in Australia with the strongest held attitudes towards gender roles and IPV had an aOR of 7.12 for IPV at baseline (95% CI 2.12-23.92) and an aOR of 10.59 for IPV at follow-up (95% CI 2.21-50.75). CONCLUSIONS Our results underscore the need for IPV prevention strategies sensitively targeted to communities from conflict-affected countries, and for awareness among clinicians of gender role attitudes that may condone men's use of IPV, and the associated risk of IPV. The study supports the need for culturally informed national strategies to promote gender equality and to challenge practices and attitudes that condone men's violence in spousal relationships.
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Affiliation(s)
- Madelyn Hsiao-Rei Hicks
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Mohammed Mohsin
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
- Mental Health Academic Unit, Liverpool Hospital, South Western Sydney Area Health Service, New South Wales, Australia
| | - Derrick Silove
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Jane Fisher
- Women and Global Health Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Batool Moussa
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Zachary Steel
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
- St John of God Health Care, Richmond Hospital, North Richmond, New South Wales, Australia
| | - Heather Nancarrow
- School of Social Sciences, Arts and Social Sciences, University of New South Wales, Kensington, New South Wales, Australia
| | - Nawal Nadar
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Louis Klein
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
- Mental Health Academic Unit, Liverpool Hospital, South Western Sydney Area Health Service, New South Wales, Australia
| | - Fatima Hasoun
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Mariam Yousif
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Batoul Khalil
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Yalini Krishna
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Susan J. Rees
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
- * E-mail:
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Loue S, Bajunirwe F. EVANGELICALISM IN UGANDA: IMPLICATIONS FOR PUBLIC HEALTH AND BIOETHICS. JOURNAL OF INTERCULTURAL MANAGEMENT AND ETHICS 2021; 4:33-49. [PMID: 38550302 PMCID: PMC10976434 DOI: 10.35478/jime.2021.2.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/01/2024]
Abstract
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.
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Affiliation(s)
- Sana Loue
- Case Western Reserve University School of Medicine, Cleveland, Ohio USA
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Fanslow J, Hashemi L, Malihi Z, Gulliver P, McIntosh T. Change in prevalence rates of physical and sexual intimate partner violence against women: data from two cross-sectional studies in New Zealand, 2003 and 2019. BMJ Open 2021; 11:e044907. [PMID: 33757950 PMCID: PMC7993160 DOI: 10.1136/bmjopen-2020-044907] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To explore changes in reported prevalence of physical and sexual intimate partner violence (IPV) between 2003 and 2019. The impact of sociodemographic differences between the two samples and between group differences were also examined. Changes in attitudes supportive of violence and in help-seeking behaviour following disclosure were also explored. DESIGN Two cross-sectional studies. SETTING AND PARTICIPANTS Cross-sectional studies on family violence conducted in New Zealand in 2003 and 2019. Ever-partnered female respondents aged 18-64 years old were included (2003 n=2674, 2019 n=944). MAIN OUTCOME MEASURES Prevalence rates of lifetime and past 12-month physical and sexual IPV, attitudes towards gender roles and acceptability of a man hitting his wife, help sought and received following disclosure were compared between the study years. RESULTS Lifetime prevalence of physical IPV was unchanged between 2003 and 2019 (AOR=0.89; 95% CI 0.73 to 1.08). There was a significant decrease in the proportion of women who reported experiencing 12-month physical IPV (AOR=0.53; 95% CI 0.29 to 0.97). Small reductions in rates for lifetime sexual IPV were also observed (AOR=0.74; 95% CI 0.59 to 0.95). In 2019, fewer women agreed with one or more statements supportive of traditional gender roles (48.1% (95% CI 45.7% to 50.5%) in 2003; 38.4% (95% CI 33.8% to 43.2%) in 2019). A significant decrease was noted in the proportion of women who sought help from informal sources (from 71.3% (95% CI 68.1% to 74.2%) in 2003 to 64.6% (95% CI 58.7% to 70.1%) in 2019). No significant changes in seeking help from formal sources, or perceived helpfulness from any source were noted. CONCLUSION While the reductions in 12-month physical and lifetime sexual IPV are positive, prevention efforts need to be established, maintained and strengthened to address the substantial lifetime prevalence of IPV. Efforts to strengthen responses from formal and informal sources continue to be needed.
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Affiliation(s)
- Janet Fanslow
- School of Population Health, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - Ladan Hashemi
- School of Population Health, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - Zarintaj Malihi
- School of Population Health, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - Pauline Gulliver
- School of Population Health, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - Tracey McIntosh
- School of Māori Studies and Pacific Studies, Faculty of Arts, The University of Auckland Faculty of Arts, Auckland, New Zealand
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Ahinkorah BO. Polygyny and intimate partner violence in sub-Saharan Africa: Evidence from 16 cross-sectional demographic and health surveys. SSM Popul Health 2021; 13:100729. [PMID: 33511263 PMCID: PMC7815814 DOI: 10.1016/j.ssmph.2021.100729] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/14/2020] [Accepted: 12/20/2020] [Indexed: 01/17/2023] Open
Abstract
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.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Belaid L, Ochola E, Bayo P, Alii GW, Ogwang M, Greco D, Zarowsky C. Exploring the impact of a community participatory intervention on women's capability: a qualitative study in Gulu Northern Uganda. BMC WOMENS HEALTH 2021; 21:28. [PMID: 33461541 PMCID: PMC7812725 DOI: 10.1186/s12905-020-01170-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 12/29/2020] [Indexed: 11/28/2022]
Abstract
Background Community participatory interventions mobilizing women of childbearing age are an effective strategy to promote maternal and child health. In 2017, we implemented this strategy in Gulu Northern Uganda. This study explored the perceived impact of this approach on women's capability. Methods We conducted a qualitative study based on three data collection methods: 14 in-depth individual interviews with participating women of childbearing age, five focus group discussions with female facilitators, and document analysis. We used the Sen capability approach as a conceptual framework and undertook a thematic analysis. Results Women adopted safe and healthy behaviors for themselves and their children. They were also able to respond to some of their family's financial needs. They reported a reduction in domestic violence and in mistreatment towards their children. The facilitators perceived improved communication skills, networking, self-confidence, and an increase in their social status. Nevertheless, the women still faced unfreedoms that deprived them of living the life they wanted to lead. These unfreedoms are related to their lack of access to economic opportunities and socio-cultural norms underlying gender inequalities. Conclusion To expand women's freedoms, we need more collective political actions to tackle gender inequalities and need to question the values underlying women's social status.
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Affiliation(s)
- Loubna Belaid
- Family Medicine Department, McGill University, 5858 Chemin de la Côte des Neiges, Montreal, QC, Canada.
| | | | - Pontius Bayo
- St. Mary's Lacor Hospital, P.O. Box 180, Gulu, Uganda
| | | | - Martin Ogwang
- St. Mary's Lacor Hospital, P.O. Box 180, Gulu, Uganda
| | - Donato Greco
- International Prevention Research Institute, Allée Claude Debussy, 69130, Écully, Lyon, France
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Correlates of intimate partner violence among urban women in sub-Saharan Africa. PLoS One 2020; 15:e0230508. [PMID: 32210457 PMCID: PMC7094863 DOI: 10.1371/journal.pone.0230508] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/03/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction The dynamics of intimate partner violence (IPV)—one of the world’s leading public health problems—in urban Africa remain poorly understood. Yet, urban areas are key to the future of women’s health in Africa. Study objectives We explored survivor-, partner-, and household-level correlates of prevalence rates for types of IPV in urban SSA women. Method The study uses DHS data from 42,143 urban women aged 15–49 in 27 SSA countries. Associations at the bivariate level were examined using the Pearson Chi-square test. The modified Poisson regression test estimated the relative prevalence of IPV subtypes in the study population at the multivariate level. Results Approximately 36% of women in urban SSA experienced at least one form of IPV; 12.8% experienced two types; and 4.6% experienced all three types. SSA urban women who had only primary-level education, had 3 or more living children, were informally employed, were in polygynous unions, or who approved of wife-beating similarly displayed higher adjusted prevalence rates for all three forms of IPV compared respectively to their counterparts without formal education, without a living child, were unemployed, in monogamous unions, or who do not approve of wife-beating. On the other hand, the region’s urban women who began cohabiting between ages 25 and 35 years or who lived in higher wealth households showed consistently lower adjusted prevalence rates for all three forms of IPV relative to their counterparts who began cohabiting before 18 years or who lived in lower wealth households. Compared to their counterparts without formal education, without a living child, or whose partners did not have formal education, women with secondary and higher education, with 1–2 living children, or whose partners had only primary level schooling displayed higher adjusted prevalence rates for both IPEV and IPPV, but not for IPSV. However, relative to their counterparts whose partners were aged 25 years or below, living with a partner aged 40 years and above was associated with statistically significant reduced prevalence rates for IPPV and IPSV, but not for IPEV. Only for IPPV did women with partners educated at secondary and above levels display statistically significant higher adjusted prevalence rates relative to their counterparts with uneducated partners. Also, solely for IPPV did women who began cohabiting between ages 18 and 24 years or whose partners were employed (whether formally or informally) show decreased adjusted prevalence rates relative to their counterparts who started cohabiting before 18 years or whose partners were unemployed. In addition, only for IPSV did women aged 40 years and above or living in middle wealth households show statistically significant reduced adjusted prevalence rates relative to their counterparts aged less than 25 years or living in lower wealth households. Discussion and conclusion By 2030, the majority of SSA women will be urban dwellers. Complexities surround IPV in urban SSA, highlighting the unique dynamics of the problem in this setting. While affirming the link between IPV and marital power inequities and dynamics, findings suggest that the specific correlates of prevalence rates for different IPV sub-types in urban SSA women can, at once, be both similar and unique. The contextual drivers of the differences and similarities in the correlates of the prevalence rates of IPV sub-types among the region’s urban women need further interrogation.
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