Association between intimate partner violence and child morbidity in South Asia

Association of Ambient Temperature With the Prevalence of Intimate Partner Violence Among Partnered Women in Low- and Middle-Income South Asian Countries

Importance

Intimate partner violence (IPV), including physical, sexual, and emotional violence, constitutes a critical public health problem, particularly in low- and middle-income countries. While climate change could escalate violent events, data quantifying its possible association with IPV are scant.

Objective

To evaluate the association of ambient temperature with the prevalence of IPV among partnered women in low- and middle-income countries in South Asia, and to estimate the association of future climate warming with IPV.

Design, Setting, and Participants

This cross-sectional study used data from the Demographic and Health Survey and included 194 871 ever-partnered women aged 15 to 49 years from 3 South Asian countries (India, Nepal, and Pakistan). The study applied the mixed-effect multivariable logistic regression model to investigate the association of ambient temperature with IPV prevalence. The study further modeled the change in IPV prevalence under various future climate change scenarios. The data included in the analyses were collected from October 1, 2010, to April 30, 2018, and the current analyses were performed from January 2, 2022, to July 11, 2022.

Exposure

Annual ambient temperature exposure for each woman, estimated based on an atmospheric reanalysis model of the global climate.

Main Outcomes and Measures

The prevalence of IPV and its types (physical, sexual, and emotional violence) were assessed based on self-reported questionnaires from October 1, 2010, to April 30, 2018, and the changes in the prevalence with climate changes were estimated through the 2090s.

Results

The study included 194 871 ever-partnered women aged 15 to 49 years (mean [SD] age, 35.4 [7.6] years; overall IPV prevalence, 27.0%) from 3 South Asian countries. The prevalence of physical violence was highest (23.0%), followed by emotional (12.5%), and sexual violence (9.5%). The annual temperature ranges were mostly between 20 °C and 30 °C. A significant association was found between high ambient temperature and the prevalence of IPV against women, with each 1 °C increase in the annual mean temperature associated with a mean increase in IPV prevalence of 4.49% (95% CI, 4.20%-4.78%). According to the study's projections under the unlimited emissions scenarios (SSPs [shared socioeconomic pathways], as defined by the Intergovernmental Panel on Climate Change] 5-8.5), IPV prevalence would increase by 21.0% by the end of the 21st century, while it would only moderately increase under increasingly stricter scenarios (SSP2-4.5 [9.8%] and SSP1-2.6 [5.8%]). In addition, the projected increases in the prevalence of physical (28.3%) and sexual (26.1%) violence were greater than that of emotional violence (8.9%). In the 2090s, India was estimated to experience the highest IPV prevalence increase (23.5%) among the 3 countries, compared with Nepal (14.8%) and Pakistan (5.9%).

Conclusions and Relevance

This cross-sectional, multicountry study provides ample epidemiological evidence to support that high ambient temperature may be associated with the risk of IPV against women. These findings highlight the vulnerabilities and inequalities of women experiencing IPV in low- and middle-income countries in the context of global climate warming.

Violence against Pregnant Women in Indonesia

BACKGROUND

Generally, violence against women, especially during pregnancy, can increase the risk of pregnancy and childbirth complications. Besides, multiple trauma may occur because it affects not only the woman but also the fetus. The present study analyzed the factors associated with violence against pregnant women in Indonesia.

METHODS

This cross-sectional study involved participants consisted of 2,553 pregnant women (aged 15-49) from the 2017 Indonesian Demographic and Health Survey data. The dependent variable was violence, while the independent variables included the characteristics of the households, respondents, and husbands/partners. In the final stage, the author calculated determinants using binary logistic regression.

RESULTS

The higher the wealth status of pregnant women, the lower the likelihood of domestic violence. The pregnant women who jointly owned a house with their husbands/partners were more likely to be violated than those who did not. Pregnant women in the high parity category were at greater risk of experiencing violence than those in the primiparous category. A husband/partner at a younger age increased the likelihood of violence among pregnant women. Finally, the pregnant women whose husbands/partners had primary/secondary education were more likely to experience violence than those whose husbands/partners had no education.

CONCLUSION

The study concluded five variables were statistically and significantly associated with violence against women in Indonesia: wealth status, homeownership, parity, husband/partner' age, and the education level of the husbands/partners.

Prevalence and determinants of fever, ARI and diarrhea among children aged 6–59 months in Bangladesh

Background

Although efforts have been made by the international community to improve childhood health, risk factors linked with the healthiness of preschool-age children in low and middle-income countries (LMICs) are very diverse. Therefore, this paper examines the prevalence and determinants of fever, acute respiratory infection and diarrhea of preschool children in Bangladesh.

Methods

A sample of 8,421 children from the latest country representative BDHS-2017–18 survey was analyzed by utilizing both the bivariate and multivariate techniques.

Results

The results revealed that about 4.7, 33.1, and 35.8% of the children aged under 5 years had suffered from diarrhea, fever and ARI respectively during the 2 weeks preceding the date of the survey. Demographic, socio-economic, and community and health characteristics likely to play an important role in suffering under-five children from diarrhea, fever, and ARI in Bangladesh. The child’s age of 13–24 months, delivery by cesarean section, unsafe drinking water, unhygienic toilet facility, low level of family wealth index and parental education, a higher number of living children in the household, rural residency and regional difference were all found to be most crucial determinants of the occurrences of fever, ARI and diarrhea.

Conclusion

Interventions should focus on improving these significant demographic, socioeconomic, and community and health risk factors. A special attention is necessary to the people who live in rural areas and geospatially disadvantaged regions.

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

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

Prevalence and determinants of intimate partner violence against mothers of children under-five years in Central Malawi

BACKGROUND

Intimate partner violence (IPV) against women is a global human rights violation and a public health problem. The phenomenon is linked to adverse health effects for women and children. Mothers of young children in Malawi can be particularly at risk because of gender-based power imbalances. The objectives of this study were to examine the prevalence and the risk factors of IPV against mothers of children under-five years of age in rural Malawi.

METHODS

A multistage, cross-sectional study design was used. A sample of 538 mothers of young children was randomly selected from postnatal clinics in Dowa district. The WHO's Violence against women screening instrument was used to collect data. Logistic regressions were used to determine risk factors that were associated with IPV against mothers.

RESULTS

Overall prevalence of all four forms of IPV against mothers of under-five children was 60.2%. The prevalence of IPV controlling behavior, psychological, physical, and sexual violence were 74.7, 49.4, 43.7 and 73.2% respectively. In multivariate analyses, mothers whose partners had extra marital affairs were more likely to experience controlling behavior (AOR: 4.97, 95% CI: 2.59-8.55, P = 0.001), psychological (AOR: 2.14, 95% CI: 1.486-3.472, P = 0.001) and physical (AOR: 2.29, 95% CI: 1.48-3.94, P = 0.001) violence than mothers whose partners did not have extra marital affairs. Mothers whose partners consume alcohol were more likely to experience sexual violence (AOR: 2.00, 95% CI: 1.17-3.41, P = 0.001) than mothers whose partners did not drink. Finally, mothers who spent more than 30 min drawing water were at greater risk of experiencing IPV than mothers who spent less than 30 min.

CONCLUSION

This study found a significantly higher prevalence of IPV against mothers of under-five children in rural Malawi compared to women in the general population. Micro and macro-level programs aimed at mitigating the partners' potential risk behaviors identified in this study are suggested. Public health programs that support increased household access to safe water are also recommended to help undermine IPV against mothers.

Prevalence and determinants of malaria infection among children of local farmers in Central Malawi

Background

Malaria is a leading cause of morbidity and mortality among children under 5 years in Malawi, and especially among those from rural areas of central Malawi. The goal of this study was to examine the prevalence and determinants of malaria infection among children in rural areas of Dowa district in central Malawi.

Methods

A multistage, cross-sectional study design was used to systematically sample 523 child-mother dyads from postnatal clinics. A survey was administered to mothers and a rapid malaria infection diagnostic test was administered to children. The main outcome was positive malaria diagnostic tests in children. Logistic regressions were used to determine risk factors associated with malaria among children aged 2 to 59 months.

Results

The prevalence of malaria among children under 5 years was 35.4%. Results suggest that children of mothers who experienced recent intimate partner violence (IPV) were more likely to be diagnosed with malaria (AOR: 1.88, 95% CI 1.19–2.97; P = 0.007) than children of mothers who did not. Children of mothers who had no formal education were more likely to be diagnosed with malaria (AOR: 2.77, 95% CI 1.24–6.19; P = 0.013) than children of mothers who had received secondary education. Children aged 2 to 5 months and 6 to 11 months were less likely to be diagnosed with malaria (AOR: 0.21, 95% CI 0.10–0.46; P = 0.000 and AOR: 0.43; 95% CI 0.22–0.85; P = 0.016, respectively) than children aged 24 to 59 months.

Conclusion

The prevalence of malaria infection among children in the study area was comparable to the national level. In addition to available malaria control programmes, further attention should be paid to children whose mothers have no formal education, children aged 24 to 59 months, and children of mothers that are exposed to IPV in the area.

Intimate Partner Violence, Maternal and Paternal Parenting, and Early Child Development

BACKGROUND AND OBJECTIVES

Previous research has demonstrated associations between maternal experience of intimate partner violence (IPV) and a range of adverse outcomes among women and their young children. However, few studies have examined the associations between maternal experience of IPV and early child development (ECD) outcomes in low- and middle-income countries (LMIC). Our objectives in this study were to examine the association between IPV victimization and ECD and assess whether the association was mediated by maternal and paternal stimulation.

METHODS

We combined cross-sectional data from the Demographic and Health Surveys for 15 202 households representing mothers and fathers of children aged 36 to 59 months in 11 LMIC. We used multivariable linear regression models to estimate the association between IPV victimization in the year preceding the survey and ECD, which we measured using the Early Child Development Index. We used path analysis to determine if the association between IPV victimization and ECD was mediated through maternal and paternal stimulation.

RESULTS

After adjusting for sociodemographic variables, IPV victimization was negatively associated with ECD (β = -.11; 95% confidence interval = -.15 to -.07). Path analysis indicated that the direct association between IPV victimization and ECD was partially and independently mediated through maternal and paternal stimulation.

CONCLUSIONS

Interventions that include components to prevent IPV may be effective for improving ECD in LMIC.

Maternal experience of intimate partner violence and its association with morbidity and mortality of children: Evidence from India

Objective

This study attempts to investigate the association between maternal exposure to intimate partner violence (IPV) and morbidity and mortality of children.

Study design

A cross-sectional study was carried out using the most recent nationally representative data of the National Family Health Survey (NFHS-4) in India.

Results

The prevalence of morbidity and mortality was higher among the children whose mothers faced physical, emotional, or sexual violence perpetrated by the partner than those who did not encounter any violence. Multivariate analysis revealed that maternal exposure to physical and sexual violence significantly increased the risks of childhood diarrhea and fever; and emotional violence was associated with an increased likelihood of diarrhea, fever, and acute respiratory infection (ARI) in the past 2 weeks among under-five children. Moreover, women’s experience of physical and emotional violence were associated with increased odds of infant mortality (<1 year) and under-five mortality (<5 years) in crude analysis. However, these associations were insignificant in the adjusted analysis. Similarly, we did not find any significant association between maternal exposure to IPV and child mortality (1 to < 5 years).

Conclusion

Maternal experience of domestic violence was associated with an increased risk of childhood morbidity (diarrhea, fever and ARI). However, no significant association was found between violence against women and mortality of children. Prevention of domestic violence may help to reduce childhood illnesses. Additional efforts are needed for maternal and child healthcare programs to improve health status of women and children.

Expressions of domestic violence against adolescents: Educators' speeches

OBJECTIVES

to describe the expressions recognized by domestic violence educators experienced by school adolescents.

METHODS

it is a qualitative study based on Paulo Freire's liberating pedagogy. Semi-structured interviews were conducted with 20 teachers from a public elementary school in the city of Salvador, state of Bahia, Brazil. The data were systematized through the Discourse of the Collective Subject.

RESULTS

collective discourse reveals that educators identify schoolchildren who experience physical, psychological and negligent abuse, being denied even love and affection.

CONCLUSIONS

although not alluding to sexual abuse, educators recognize that students are inserted in the context of domestic violence, knowledge necessary for the development of actions that enable the exit of the student from the oppressed and overcoming the lived experience.

Intimate partner violence and childhood illnesses in Cambodia: a cross-sectional study

BACKGROUND

Around a quarter of Cambodian women reported being victim to intimate partner violence (IPV) from their current partner. Children's exposure to familial IPV impacts psychosocial well-being and emerging research indicates associations with physical health.

OBJECTIVE

Investigate associations between maternal experience of IPV and common childhood illnesses in Cambodia.

DESIGN, SETTING, PARTICIPANTS

Analysis of the Cambodia Demographic and Health Survey (2000, 2005, 2014) using logistic regression, including 5025 children under 5 years of age whose mothers responded to questions about experience of emotional, physical and sexual violence by current partner.

MAIN OUTCOME MEASURES

Report of diarrhoea, acute respiratory infection (ARI) or fever, respectively, in children in the two weeks preceding the survey.

RESULTS

Children of mothers with experience of any type of IPV had estimated elevated odds of diarrhoea (adjusted OR (aOR)=1.65, 95% CI 1.39 to 1.97), estimated odds of ARI (aOR=1.78, 95% CI 1.47 to 2.16) and estimated odds of fever (aOR=1.51, 95% CI 1.31 to 1.76) compared with children of mothers without reported IPV experience. Exposure to any form of IPV corresponded to an estimated 2.65 times higher odds (95% CI 2.01 to 3.51) for reporting having both diarrhoea and ARI.

CONCLUSIONS

Our findings support the notion that children's susceptibility to diarrhoea, ARI and fever may be affected by mothers' experience of IPV, including emotional violence. Maternal and child health programmes should train healthcare professionals to identify domestic violence and children at risk, and link victims to appropriate health and legal services.

Maternal psychosocial risk factors and lower respiratory tract infection (LRTI) during infancy in a South African birth cohort

Objective

To investigate the association between maternal antenatal and/or postnatal psychosocial risk factors (including depression, psychological distress, alcohol abuse and intimate partner violence (IPV) and infant lower respiratory tract infection (LRTI) in a low- and middle-income-country (LMIC).

Study design

Pregnant women (n = 1137) enrolled in a South African birth cohort study, the Drakenstein Child Health Study (DCHS) were longitudinally assessed for psychosocial risk factors including depression, psychological distress, alcohol abuse and/or intimate partner violence (IPV). Infants were followed from birth until one year of age for the development of LRTI by active surveillance. Two outcomes were evaluated: any LRTI, and severe and/or hospitalised LRTI. Logistic regression was used to identify associations between individual maternal psychosocial risk factors and LRTI outcomes. Analyses stratified by age were also performed to determine which age groups related to infant LRTI were linked with maternal psychosocial risk factors.

Results

There were 606 LRTI episodes in 369 infants in the first year (crude incidence rate = 0.53 episodes per person-year, 95%CI: 0.50; 0.56); 31% (n = 186) of episodes were severe or hospitalised events. Maternal psychosocial risk factors were associated with LRTI and severe LRTI, particularly postnatal and long-term maternal psychological distress, antenatal maternal alcohol consumption, and postnatal maternal IPV. Age stratified analyses found that antenatal maternal alcohol consumption was associated with early infant LRTI, while antenatal maternal depression was linked with infant severe LRTI between 3 and 6 months of age, and postnatal maternal IPV was associated with early LRTI and severe forms of LRTI.

Conclusion

The associations between maternal psychosocial risk factors and infant LRTI highlight the potential value of screening for maternal psychosocial risk factors in clinical settings and developing targeted interventions. Such interventions may not only improve maternal well-being, but also help reduce the burden of infant LRTI in LMIC settings.

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

INTRODUCTION

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

MATERIAL AND METHODS

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

RESULTS

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

CONCLUSION

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

Intimate partner violence against married rural-to-urban migrant workers in eastern China: prevalence, patterns, and associated factors

BACKGROUND

Intimate partner violence (IPV) is a significant public health issue among married rural-to-urban migrant workers, the largest group of internal migrants in China. This study aims to explore the prevalence, patterns and associated factors of intimate partner violence against married rural-to-urban migrant workers in eastern China.

METHODS

A cross-sectional study was conducted in Zhejiang province in China between July 2015 and April 2016, and a total of 1,744 married rural-to-urban migrant workers ultimately took part in the study. Conflict Tactics Scales and several short demographic questions were applied. Data were principally analyzed with logistic regression.

RESULTS

The majority of married rural-to-urban migrant workers were middle-aged couples with a low education level and a relatively long-term duration of migration in fixed migrant cities. Nearly 45% of married rural-to-urban migrant workers were experienced at least one incident of intimate partner violence during the past 12 months. The joint occurrence of multiple forms of violence is the most commonly reported features of intimate partner violence, especially three overlapping patterns of intimate partner violence. Some individual (education and age), relationship (marital satisfaction, premarital sex and extramarital affairs) and social (duration of migration and number of migratory cities) factors of the respondents, were negatively or positively associated with intimate partner violence against married rural-to-urban migrant workers.

CONCLUSION

The results indicated that one out of two married rural-to-urban migrant workers experienced at least one incident of intimate partner violence during the past 12 months in China. Accordingly, there is an obvious demand of intervention and treatment activities to prevent and reduce the occurrence of intimate partner violence among the millions of migrant workers in China.