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Fletcher R, Forbes F, Dadi AF, Kassa GM, Regan C, Galle A, Beyene A, Liackman R, Temmerman M. Effect of male partners' involvement and support on reproductive, maternal and child health and well-being in East Africa: A scoping review. Health Sci Rep 2024; 7:e2269. [PMID: 39086507 PMCID: PMC11286546 DOI: 10.1002/hsr2.2269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 06/23/2024] [Accepted: 07/16/2024] [Indexed: 08/02/2024] Open
Abstract
Background and Aims East African countries have high rates of maternal and child mortality and morbidity. Studies have shown that the involvement of male partners in reproductive health can benefit maternal and child health (MCH). This scoping review aims to provide an overview of the evidence across East Africa that describes male partner involvement and its effect on maternal, reproductive, and child well-being. Methods Ten databases were searched to identify quantitative data on male's involvement in East Africa. Studies reporting qualitative data, "intention to use" data or only reporting on male partner's education or economic status were excluded. Studies were organized into five a priori categories: antenatal care (ANC), human immunodeficiency virus, breastfeeding, family planning, and intimate partner violence with further categories developed based on studies included. Results A total of 2787 records were identified; 644 full texts were reviewed, and 96 studies were included in this review. Data were reported on 118,967 mothers/pregnant women and 15,361 male partners. Most of the studies (n = 83) were reported from four countries Ethiopia (n = 49), Kenya (n = 14), Tanzania (n = 12) and Uganda (n = 10). The evidence indicates that male partner involvement and support is associated with improved reproductive, MCH across a wide range of outcomes. However, the studies were heterogeneous, using diverse exposure and outcome measures. Also, male partners' lack of practical and emotional support, and engagement in violent behaviors towards partners, were associated with profound negative impacts on MCH and well-being. Conclusions The body of evidence, although heterogeneous, provides compelling support for male involvement in reproductive health programs designed to support MCH. To advance research in this field, an agreement is needed on a measure of male partner "involvement." To optimize benefits of male partners' involvement, developing core outcome sets and regional coordination are recommended.
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Affiliation(s)
- Richard Fletcher
- College of Health, Medicine and WellbeingThe University of NewcastleCallaghanNew South WalesAustralia
| | - Faye Forbes
- College of Health SciencesDebre Markos UniversityDebre MarkosEthiopia
- Global and Women's Health Unit, School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Abel Fekadu Dadi
- Menzies School of Health ResearchCharles Darwin University, NT, Australia & Addis Continental Institute of Public HealthAddis AbabaEthiopia
| | | | - Casey Regan
- College of Health, Medicine and WellbeingThe University of NewcastleCallaghanNew South WalesAustralia
| | - Anna Galle
- Department Public Health and Primary CareInternational Centre for Reproductive Health, Ghent UniversityGhentBelgium
| | - Addisu Beyene
- School of Public Health, College of Health and Medical SciencesHaramaya UniversityHararEthiopia
- Centre for Women's Health Research, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleAustralia
| | - Rebecca Liackman
- College of Health, Medicine and WellbeingThe University of NewcastleCallaghanNew South WalesAustralia
| | - Marleen Temmerman
- Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
- Centre of Excellence in Women and Child HealthAga Khan UniversityNairobiKenya
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Sabri B, Mani SS, Kaduluri VPS. Integrated domestic violence and reproductive health interventions in India: a systematic review. Reprod Health 2024; 21:94. [PMID: 38951870 PMCID: PMC11218333 DOI: 10.1186/s12978-024-01830-0] [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: 01/10/2024] [Accepted: 06/12/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Domestic violence is a leading cause of poor health outcomes during pregnancy and the postpartum period. Therefore, there is a need for integrated domestic violence interventions in reproductive health care settings. India has one of the highest maternal and child mortality rates. This review aimed to identify characteristics of existing evidence-based integrated domestic violence and reproductive healthcare interventions in India to identify gaps and components of interventions that demonstrate effectiveness for addressing domestic violence. METHODS A systematic review of intervention studies was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Three research team members performed independent screening of title, abstracts and full-texts. RESULTS The search resulted in 633 articles, of which 13 articles met inclusion criteria for full text screening and analysis. Common components of integrated violence and reproductive health interventions that were effective in addressing domestic violence included: psychoeducation/education (n = 5), skill building (n = 5), counseling (n = 5), engaging stakeholders with use of trained lay peer facilitators (n = 3), and engaging male spouses (n = 3). CONCLUSIONS Interventions in India for domestic violence that are integrated with reproductive health care remain few, and there are fewer with effective outcomes for domestic violence. Of those with effective outcomes, all of the interventions utilized psychoeducation/education, skill building, and counseling as part of the intervention.
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Affiliation(s)
- Bushra Sabri
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Room N530L, Baltimore, MD, 21205, USA.
| | - Serena Sloka Mani
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Bhatt Carreno S, Orjuela-Grimm M, Vahedi L, Roesch E, Heckman C, Beckingham A, Gayford M, Meyer SR. Linkages between maternal experience of intimate partner violence and child nutrition outcomes: A rapid evidence assessment. PLoS One 2024; 19:e0298364. [PMID: 38498450 PMCID: PMC10947923 DOI: 10.1371/journal.pone.0298364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 01/24/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND A strong evidence base indicates that maternal caregivers' experience of intimate partner violence [IPV] impacts children's health, cognitive development, and risk-taking behaviors. Our objective was to review peer-reviewed literature describing the associations between a child's indirect exposure to IPV and corresponding nutrition outcomes, with a particular focus on fragile settings in low and middle-income countries [LMICs]. METHODS We conducted a rapid evidence assessment to synthesize quantitative associations between maternal caregivers' IPV experience and children's nutrition/growth outcomes (birthweight, feeding, and growth indicators). We included peer-reviewed research, published in English or Spanish after the year 2000, conducted in fragile settings in LMICs. RESULTS We identified 86 publications that fit inclusion criteria. Amongst all associations assessed, a maternal caregiver's experience of combined forms of IPV (physical, sexual and emotional) or physical IPV only, were most consistently associated with lower birthweight, especially during pregnancy. Women of child-bearing age, including adolescents, exposed to at least one type of IPV showed a decreased likelihood of following recommended breastfeeding practices. Lifetime maternal experience of combined IPV was significantly associated with stunting among children under 5 years of age in the largest study included, though findings in smaller studies were inconsistent. Maternal experience of physical or combined IPV were inconsistently associated with underweight or wasting in the first five years. Maternal experience of sexual IPV during pregnancy appeared to predict worsened lipid profiles among children. CONCLUSION Maternal caregivers' experience of IPV is significantly associated with low birthweight and suboptimal breastfeeding practices, whereas studies showed inconsistent associations with child growth indicators or blood nutrient levels. Future research should focus on outcomes in children aged 2 years and older, investigation of feeding practices beyond breastfeeding, and examination of risk during time periods physiologically relevant to the outcomes. Programmatic implications include incorporation of GBV considerations into nutrition policies and programming and integrating GBV prevention and response into mother and child health and nutrition interventions in LMIC contexts.
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Affiliation(s)
- Silvia Bhatt Carreno
- Department of Epidemiology, Columbia University, New York City, New York, United States of America
| | - Manuela Orjuela-Grimm
- Department of Epidemiology and Pediatrics, Columbia University Irving Medical Center, New York City, New York, United States of America
| | - Luissa Vahedi
- Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | | | | | | | - Megan Gayford
- UNICEF, New York City, New York, United States of America
| | - Sarah R. Meyer
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
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Leslie K, Barker LC, Brown HK, Chen S, Dennis CL, Ray JG, Saunders N, Taylor C, Vigod S. Risk of interpersonal violence during and after pregnancy among people with schizophrenia: a population-based cohort study. CMAJ 2023; 195:E322-E329. [PMID: 36878538 PMCID: PMC9987232 DOI: 10.1503/cmaj.220689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Schizophrenia is associated with increased risk of experiencing interpersonal violence. Little is known about risk specifically around the time of pregnancy. METHODS This population-based cohort study included all individuals (aged 15-49 yr) listed as female on their health cards who had a singleton birth in Ontario, Canada, between 2004 and 2018. We compared those with and without schizophrenia on their risk of an emergency department (ED) visit for interpersonal violence in pregnancy or within 1 year postpartum. We adjusted relative risks (RRs) for demographics, prepregnancy history of substance use disorder and history of interpersonal violence. In a subcohort analysis, we used linked clinical registry data to evaluate interpersonal violence screening and self-reported interpersonal violence during pregnancy. RESULTS We included 1 802 645 pregnant people, 4470 of whom had a diagnosis of schizophrenia. Overall, 137 (3.1%) of those with schizophrenia had a perinatal ED visit for interpersonal violence, compared with 7598 (0.4%) of those without schizophrenia, for an RR of 6.88 (95% confidence interval [CI] 5.66-8.37) and an adjusted RR of 3.44 (95% CI 2.86-4.15). Results were similar when calculated separately for the pregnancy (adjusted RR 3.47, 95% CI 2.68-4.51) period and the first year postpartum (adjusted RR 3.45, 95% CI 2.75-4.33). Pregnant people with schizophrenia were equally likely to be screened for interpersonal violence (74.3% v. 73.8%; adjusted RR 0.99, 95% CI 0.95-1.04), but more likely to self-report it (10.2% v. 2.4%; adjusted RR 3.38, 95% CI 2.61-4.38), compared with those without schizophrenia. Among patients who did not self-report interpersonal violence, schizophrenia was associated with an increased risk for a perinatal ED visit for interpersonal violence (4.0% v. 0.4%; adjusted RR 6.28, 95% CI 3.94-10.00). INTERPRETATION Pregnancy and postpartum are periods of higher risk for interpersonal violence among people with schizophrenia compared with those without schizophrenia. Pregnancy is a key period for implementing violence prevention strategies in this population.
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Affiliation(s)
- Kelly Leslie
- Departments of Psychiatry (Leslie, Barker, Dennis, Vigod), of Medicine (Ray) and of Pediatrics (Saunders), Temerty Faculty of Medicine, University of Toronto; Women's College Hospital and Women's College Research Institute (Barker, Brown, Dennis, Taylor, Vigod); Institute for Health Policy, Management and Evaluation (Barker, Brown, Ray, Saunders, Vigod); ICES (Barker, Brown, Chen, Ray, Saunders, Taylor, Vigod); Department of Health and Society (Brown), University of Toronto; Lawrence S. Bloomberg Faculty of Nursing (Dennis), University of Toronto; St. Michael's Hospital (Ray); Edwin Leong Centre for Healthy Children (Saunders), Hospital for Sick Children, Toronto, Ont
| | - Lucy C Barker
- Departments of Psychiatry (Leslie, Barker, Dennis, Vigod), of Medicine (Ray) and of Pediatrics (Saunders), Temerty Faculty of Medicine, University of Toronto; Women's College Hospital and Women's College Research Institute (Barker, Brown, Dennis, Taylor, Vigod); Institute for Health Policy, Management and Evaluation (Barker, Brown, Ray, Saunders, Vigod); ICES (Barker, Brown, Chen, Ray, Saunders, Taylor, Vigod); Department of Health and Society (Brown), University of Toronto; Lawrence S. Bloomberg Faculty of Nursing (Dennis), University of Toronto; St. Michael's Hospital (Ray); Edwin Leong Centre for Healthy Children (Saunders), Hospital for Sick Children, Toronto, Ont
| | - Hilary K Brown
- Departments of Psychiatry (Leslie, Barker, Dennis, Vigod), of Medicine (Ray) and of Pediatrics (Saunders), Temerty Faculty of Medicine, University of Toronto; Women's College Hospital and Women's College Research Institute (Barker, Brown, Dennis, Taylor, Vigod); Institute for Health Policy, Management and Evaluation (Barker, Brown, Ray, Saunders, Vigod); ICES (Barker, Brown, Chen, Ray, Saunders, Taylor, Vigod); Department of Health and Society (Brown), University of Toronto; Lawrence S. Bloomberg Faculty of Nursing (Dennis), University of Toronto; St. Michael's Hospital (Ray); Edwin Leong Centre for Healthy Children (Saunders), Hospital for Sick Children, Toronto, Ont
| | - Simon Chen
- Departments of Psychiatry (Leslie, Barker, Dennis, Vigod), of Medicine (Ray) and of Pediatrics (Saunders), Temerty Faculty of Medicine, University of Toronto; Women's College Hospital and Women's College Research Institute (Barker, Brown, Dennis, Taylor, Vigod); Institute for Health Policy, Management and Evaluation (Barker, Brown, Ray, Saunders, Vigod); ICES (Barker, Brown, Chen, Ray, Saunders, Taylor, Vigod); Department of Health and Society (Brown), University of Toronto; Lawrence S. Bloomberg Faculty of Nursing (Dennis), University of Toronto; St. Michael's Hospital (Ray); Edwin Leong Centre for Healthy Children (Saunders), Hospital for Sick Children, Toronto, Ont
| | - Cindy-Lee Dennis
- Departments of Psychiatry (Leslie, Barker, Dennis, Vigod), of Medicine (Ray) and of Pediatrics (Saunders), Temerty Faculty of Medicine, University of Toronto; Women's College Hospital and Women's College Research Institute (Barker, Brown, Dennis, Taylor, Vigod); Institute for Health Policy, Management and Evaluation (Barker, Brown, Ray, Saunders, Vigod); ICES (Barker, Brown, Chen, Ray, Saunders, Taylor, Vigod); Department of Health and Society (Brown), University of Toronto; Lawrence S. Bloomberg Faculty of Nursing (Dennis), University of Toronto; St. Michael's Hospital (Ray); Edwin Leong Centre for Healthy Children (Saunders), Hospital for Sick Children, Toronto, Ont
| | - Joel G Ray
- Departments of Psychiatry (Leslie, Barker, Dennis, Vigod), of Medicine (Ray) and of Pediatrics (Saunders), Temerty Faculty of Medicine, University of Toronto; Women's College Hospital and Women's College Research Institute (Barker, Brown, Dennis, Taylor, Vigod); Institute for Health Policy, Management and Evaluation (Barker, Brown, Ray, Saunders, Vigod); ICES (Barker, Brown, Chen, Ray, Saunders, Taylor, Vigod); Department of Health and Society (Brown), University of Toronto; Lawrence S. Bloomberg Faculty of Nursing (Dennis), University of Toronto; St. Michael's Hospital (Ray); Edwin Leong Centre for Healthy Children (Saunders), Hospital for Sick Children, Toronto, Ont
| | - Natasha Saunders
- Departments of Psychiatry (Leslie, Barker, Dennis, Vigod), of Medicine (Ray) and of Pediatrics (Saunders), Temerty Faculty of Medicine, University of Toronto; Women's College Hospital and Women's College Research Institute (Barker, Brown, Dennis, Taylor, Vigod); Institute for Health Policy, Management and Evaluation (Barker, Brown, Ray, Saunders, Vigod); ICES (Barker, Brown, Chen, Ray, Saunders, Taylor, Vigod); Department of Health and Society (Brown), University of Toronto; Lawrence S. Bloomberg Faculty of Nursing (Dennis), University of Toronto; St. Michael's Hospital (Ray); Edwin Leong Centre for Healthy Children (Saunders), Hospital for Sick Children, Toronto, Ont
| | - Clare Taylor
- Departments of Psychiatry (Leslie, Barker, Dennis, Vigod), of Medicine (Ray) and of Pediatrics (Saunders), Temerty Faculty of Medicine, University of Toronto; Women's College Hospital and Women's College Research Institute (Barker, Brown, Dennis, Taylor, Vigod); Institute for Health Policy, Management and Evaluation (Barker, Brown, Ray, Saunders, Vigod); ICES (Barker, Brown, Chen, Ray, Saunders, Taylor, Vigod); Department of Health and Society (Brown), University of Toronto; Lawrence S. Bloomberg Faculty of Nursing (Dennis), University of Toronto; St. Michael's Hospital (Ray); Edwin Leong Centre for Healthy Children (Saunders), Hospital for Sick Children, Toronto, Ont
| | - Simone Vigod
- Departments of Psychiatry (Leslie, Barker, Dennis, Vigod), of Medicine (Ray) and of Pediatrics (Saunders), Temerty Faculty of Medicine, University of Toronto; Women's College Hospital and Women's College Research Institute (Barker, Brown, Dennis, Taylor, Vigod); Institute for Health Policy, Management and Evaluation (Barker, Brown, Ray, Saunders, Vigod); ICES (Barker, Brown, Chen, Ray, Saunders, Taylor, Vigod); Department of Health and Society (Brown), University of Toronto; Lawrence S. Bloomberg Faculty of Nursing (Dennis), University of Toronto; St. Michael's Hospital (Ray); Edwin Leong Centre for Healthy Children (Saunders), Hospital for Sick Children, Toronto, Ont.
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Da Thi Tran T, Murray L, Van Vo T. Intimate partner violence during pregnancy and maternal and child health outcomes: a scoping review of the literature from low-and-middle income countries from 2016 - 2021. BMC Pregnancy Childbirth 2022; 22:315. [PMID: 35418053 PMCID: PMC9006493 DOI: 10.1186/s12884-022-04604-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/14/2022] [Indexed: 12/23/2022] Open
Abstract
Background Intimate partner violence (IPV) during pregnancy is significantly associated with negative outcomes for both mother and child. Current evidence indicates an association between low levels of social support and IPV, however there is less evidence from low-and-middle income countries (LMIC) than high-income countries. Globally, the COVID-19 pandemic has radically altered how women can access social support. Hence since 2020, studies investigating IPV and pregnancy have occurred within the changing social context of the pandemic. Objective This scoping review summarizes the evidence from LMICs about the effects of IPV during pregnancy on maternal and child health. The review includes the impact of the COVID-19 pandemic on social support as mentioned in studies conducted since 2020. Design Library databases were used to identify papers from 2016 to 2021. These studies reported the maternal and child health outcomes of IPV during pregnancy, and described how social support during pregnancy, and the COVID-19 pandemic, were associated with rates of IPV during pregnancy. Observational study designs, qualitative and mixed methods studies were included. Results Twenty - six studies from 13 LMICs were included. Half (n = 13) were cross sectional studies which only collected data at one time-point. IPV during pregnancy was significantly associated with higher odds of postpartum depression, low birth weight, preterm birth and less breastfeeding in the year after birth. Lower levels of social support increased the odds of experiencing IPV during pregnancy, whilst higher levels of social support reduced antenatal anxiety and depression in women experiencing IPV during pregnancy. Of the four studies that investigated IPV during pregnancy throughout the COVID-19 pandemic, only one compared prevalence before and after the pandemic and unexpectedly reported a lower prevalence. Conclusions Further research on the impact of IPV during pregnancy on maternal and child outcomes in LMICs is required, especially evidence from longitudinal studies investigating a wider range of outcomes. To date, there is limited evidence on the impact of the COVID-19 pandemic on IPV during pregnancy in LMICs, and this should be prioritized as the pandemic continues to affect women’s access to social support globally. Supplementary information The online version contains supplementary material available at 10.1186/s12884-022-04604-3.
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Affiliation(s)
- Thao Da Thi Tran
- School of Health Sciences, College of Health, Massey University, Wellington, Aotearoa, New Zealand
| | - Linda Murray
- School of Health Sciences, College of Health, Massey University, Wellington, Aotearoa, New Zealand.
| | - Thang Van Vo
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam.,Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
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Montiel Ishino FA, Rowan C, Ambikile JS, Conserve DF, Lopez D, Sabado-Liwag M, Williams F. Intimate partner violence and HIV testing during antenatal care: A latent class analysis to identify risk factors for HIV infection in mothers and their children in the United Republic of Tanzania. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000831. [PMID: 36962397 PMCID: PMC10021740 DOI: 10.1371/journal.pgph.0000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022]
Abstract
Intimate partner violence has adverse effects on mother's overall health and prevention of mother to child HIV transmission. To identify and examine subgroups of mothers experiencing intimate partner violence and the likelihood of HIV testing during antenatal care, we conducted a latent class analysis using data from the Tanzania Demographic and Health Survey 2010 (N = 2,809). Intimate partner violence included mother's experiences with partners' controlling behaviors, as well as emotional, physical, and sexual violence. The outcome was mother's accepting HIV testing offered during their antenatal care visit. Covariates included mother's level of education, rural/urban residence, and prevention of mother to child HIV transmission talk during antenatal care visit. The latent class analysis indicated a three-class solution was the best model and identified the following profiles: mothers with no experience of intimate partner violence (61% of sample) with a 90.5% likelihood of HIV testing; mothers with moderate levels of intimate partner violence (26%) with an 84.7% likelihood of testing; and mothers with extreme levels of intimate partner violence (13%) with an 82% likelihood of testing. An auxiliary multinomial logistic regression with selected covariates was conducted to further differentiate IPV profiles, where mothers with extreme levels of intimate partner violence had 57% increased odds [95%CI:1.06-2.33, p = .023] of living in rural areas compared to mothers with no experience of intimate partner violence. Our person-centered methodological approach provided a novel model to understand the impact of multiple intimate partner violence risk factors on antenatal care HIV testing to identify mothers in need of interventions and their children at highest for parent to child HIV transmission. Our model allows person-centered interventional designs tailored for the most at-risk subgroups within a population.
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Affiliation(s)
- Francisco A Montiel Ishino
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, United States of America
- Transdisciplinary Center for Health Equity Research, College of Education and Human Development, Texas A&M University, College Station, Texas, United States of America
| | - Claire Rowan
- Transdisciplinary Center for Health Equity Research, College of Education and Human Development, Texas A&M University, College Station, Texas, United States of America
| | - Joel Seme Ambikile
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Donaldson F Conserve
- Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, United States of America
| | - Diana Lopez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Melanie Sabado-Liwag
- Department of Public Health, California State University, Los Angeles, Los Angeles, California, United States of America
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, United States of America
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Walters CN, Rakotomanana H, Komakech JJ, Stoecker BJ. Maternal experience of intimate partner violence is associated with suboptimal breastfeeding practices in Malawi, Tanzania, and Zambia: insights from a DHS analysis. Int Breastfeed J 2021; 16:20. [PMID: 33602285 PMCID: PMC7890985 DOI: 10.1186/s13006-021-00365-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite widespread suboptimal breastfeeding practices and maternal experiences of intimate partner violence (IPV), the association of IPV and breastfeeding practices remains unclear. This study investigated the associations between maternal experience of physical, sexual, emotional violence, and controlling behaviors with suboptimal breastfeeding practices in Malawi, Tanzania, and Zambia. METHODS Data included mother-infant dyads from the most recent Demographic and Health Surveys for Malawi (n = 1878), Tanzania (n = 3184), and Zambia (n = 3879). Intimate partner violence (physical, sexual, and emotional) was measured using the Revised Conflict Tactics Scale. Breastfeeding practices were early initiation of breastfeeding (within 1 h of birth), exclusive breastfeeding (in previous 24 h), and continued breastfeeding. Associations between experience of physical, sexual, or emotional violence or controlling behaviors and breastfeeding practices, as well as associations between the frequency of IPV and breastfeeding practices were assessed. RESULTS Many Malawian (77.6%) and Zambian (67.7%) and just over half (53.6%) of Tanzanian mothers, initiated breastfeeding within 1 h of birth. Exclusive breastfeeding was 70.6% in Zambia and 60.1% in Malawi, while 55.0% of Tanzanian mothers breastfed exclusively. Continued breastfeeding to at least 1 year was high in Malawi 92.2%, Tanzania 93.4%, and Zambia 95.0%. Most mothers reported experiences of IPV in Tanzania 79.1%, Zambia 78.9%, and Malawi 73.9%. Mothers who experienced sexual IPV were significantly more likely to delay breastfeeding (Malawi [AOR 1.55 (1.14, 2.10)]; Tanzania [AOR 1.30 (1.04, 1.62)]; and Zambia [AOR 1.28 (1.06, 1.54)]). Sexual IPV in Malawi and Zambia was associated with greater odds of not exclusively breastfeeding (Malawi [AOR 1.90 (1.05, 3.45)]; Zambia [AOR 1.75 (1.15, 2.67)]). Tanzanian mothers who experienced IPV often or sometimes were two times more likely not to breastfeed at one-year post-delivery [AOR 2.23 (1.09,4.57)]. CONCLUSIONS In the three countries investigated maternal experience of IPV was associated with suboptimal breastfeeding practices. Policies and programs targeting improved breastfeeding practices should consider screening during antenatal and postnatal care for experience of violence and support initiatives to reduce IPV.
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Affiliation(s)
- Christine N Walters
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA.
| | - Hasina Rakotomanana
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Joel J Komakech
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Barbara J Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
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Normann AK, Bakiewicz A, Kjerulff Madsen F, Khan KS, Rasch V, Linde DS. Intimate partner violence and breastfeeding: a systematic review. BMJ Open 2020; 10:e034153. [PMID: 33130559 PMCID: PMC7783610 DOI: 10.1136/bmjopen-2019-034153] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 08/11/2020] [Accepted: 09/21/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The association between intimate partner violence (IPV) and breastfeeding is unclear. We conducted a systematic review to summarise the evidence of breastfeeding outcomes following exposure to IPV. DESIGN Systematic review. METHODS We searched for published studies without study design or language restrictions (up to July 2019) in the following databases: PubMed, Embase, SCOPUS and The Global Health Library. Studies assessing various breastfeeding outcomes (initiation, duration and exclusive breastfeeding) in women exposed to IPV in any form (physical, psychological or sexual) and at any stage (1 year pre-pregnancy, during or post-pregnancy) were included. Two authors independently selected the studies and conducted the quality appraisal by use of the Newcastle-Ottawa Scale. Results were summarised taking precision and quality into account. RESULTS A total of 16 studies (participants n=414 393) were included and they adjusted for a total of 48 different confounders. The majority of studies were cross-sectional (n=11) and most studies were judged to be fair/low quality. Four out of seven studies found that IPV exposure shortened breastfeeding duration (adjusted ORs/aORs=0.22 (95% CI: 0.05-0.85), 1.18 (95% CI: 1.01-1.37), 5.92 (95% CI: 1.72-27.98), 1.28 (95% CI: 1.18-1.39)). Further, 5/10 studies found that IPV led to early termination of exclusive breastfeeding (aORs=1.53 (95% CI: 1.01-23.1), 0.83 (95% CI: 0.71-0.96), 1.35 (95% CI: 1.07-1.71), 0.17 (95% CI: 0.07-0.4), 1839 (95% CI: 1.61-2911)) and 2/6 studies found that IPV significantly reduced breastfeeding initiation (aORs=2.00 (95% CI: 1.2-3.3), 0.81 (95% CI: 0.7-0.93)). CONCLUSION IPV exposure appears to associate negatively with some breastfeeding outcomes. Individual patient data meta-analysis is required to quantify the magnitude of the association for specific IPV-outcome combinations. More high-quality studies and definition of core confounders are warranted. PROSPERO REGISTRATION NUMBER CRD42019129353.
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Affiliation(s)
- Anne Katrine Normann
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Aleksandra Bakiewicz
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - Vibeke Rasch
- Obstetrics and Gynaecology, Odense Universitetshospital, Odense, Denmark
- Institute of Clinical Research, Syddansk Universitet, Odense, Denmark
| | - Ditte Søndergaard Linde
- Obstetrics and Gynaecology, Odense Universitetshospital, Odense, Denmark
- Institute of Clinical Research, Syddansk Universitet, Odense, Denmark
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Ribeiro MRC, Batista RFL, Schraiber LB, Pinheiro FS, Santos AMD, Simões VMF, Confortin SC, Aristizabal LYG, Yokokura AVCP, Silva AAMD. Recurrent Violence, Violence with Complications, and Intimate Partner Violence Against Pregnant Women and Breastfeeding Duration. J Womens Health (Larchmt) 2020; 30:979-989. [PMID: 32936043 DOI: 10.1089/jwh.2020.8378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Few studies have investigated the association between violence against pregnant women in terms of recurrence, complications, and perpetrators of violence, and breastfeeding duration. This study verifies whether recurrent violence, violence with pregnancy complications, and intimate partner violence (IPV) against pregnant women are associated with shorter exclusive breastfeeding up to the infant's 6th month and breastfeeding up to the 12th month of life. Materials and Methods: A cohort study with a convenience sample of 1,146 pregnant women was performed. Follow-up assessments were conducted at birth, and at 12-36 months. Survival analysis was used to verify whether recurrent violence, violence with pregnancy complications, and IPV were associated with reduced duration of exclusive breastfeeding and breastfeeding. Results: The adjusted Cox regression revealed no difference regarding exclusive breastfeeding duration among mothers exposed or not exposed to violence and according to who perpetrated the violence. The risk of an infant not being breastfed within the first 12 months of life increased in cases of violence before/during pregnancy (95% confidence interval [CI] = 1.03-1.88), recurrent psychological/physical/sexual violence during pregnancy (95% CI = 1.11-1.92), recurrent psychological violence (95% CI = 1.05-1.96), and recurrent physical/sexual violence (95% CI = 1.01-2.39). Violence with pregnancy complications (95% CI = 0.94-2.22) was not associated with breastfeeding interruption. Similar risks of breastfeeding interruption were observed for IPV (95% CI = 0.96-1.87) and violence perpetrated by other family members (95% CI = 0.83-1.89). Conclusions: We observed a shorter breastfeeding duration up to 12 months of life in cases of recurrent violence.
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Affiliation(s)
| | | | | | | | | | | | - Susana Cararo Confortin
- Postgraduation Program in Collective Health, Federal University of Maranhão, São Luís, Brazil
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