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Sapkota PM, Pandey AR, Adhikari B, Shrestha G, Piya R, Lamichhane B, Garu S, Joshi D, Baral SC. Intimate partner violence in Nepal: Analysis of Nepal Demographic and Health Survey 2022. PLoS One 2024; 19:e0308107. [PMID: 39150935 PMCID: PMC11329113 DOI: 10.1371/journal.pone.0308107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 01/14/2024] [Accepted: 07/15/2024] [Indexed: 08/18/2024] Open
Abstract
INTRODUCTION Intimate partner violence (IPV) is a major public health issue in Nepal. IPV has social and economic impacts on women, family, and the wider society. In this study, we aimed to determine factors associated with IPV among currently partnered women aged 15-49. METHODS We conducted a secondary data analysis of the Nepal Demographic and Health Survey (NDHS) 2022. The study examines the lifetime prevalence of IPV. IPV was measured in three domains: experience of physical violence, emotional violence, and sexual violence. Weighted univariate and multivariable logistic regression analysis were applied to determine factors associated with IPV. The results of logistic regression were presented as crude odds ratio (COR) and adjusted odds ratio (AOR) and their 95% confidence interval (CI). RESULTS Of 3853 women, 27.2% had experienced any form of IPV. The lifetime prevalence of physical violence, emotional violence, and sexual violence were 23.2%, 12.8%, and 7.1%, respectively. Higher odds of physical violence were reported among women aged 35-49 years (AOR: 2.13, 95% CI: 1.58-2.87), women without formal education (AOR: 1.51, 95% CI: 1.10-2.06), and women who justified wife-beating (AOR: 1.23, 95% CI: 1.00-1.52). Women from poor households (AOR: 1.61, 95% CI: 1.12-2.35) and women with uneducated partners (AOR: 1.66, 95% CI: 1.08-2.58) were at higher risk of experiencing sexual violence. Women with unemployed husbands reported a higher risk of physical violence (AOR: 2.72, 95% CI: 1.45-5.06) and emotional violence (AOR: 1.61, 95% CI: 1.12-2.35). CONCLUSION Almost one in three currently partnered women experienced some form of IPV in their lifetime. Various sociodemographic, partner-related, and women's empowerment-related factors were associated with experiencing IPV. Acknowledging and addressing these factors is essential to mitigating the high rates of IPV among reproductive aged women.
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Affiliation(s)
- Parash Mani Sapkota
- Research, Evaluation and Innovation Department, HERD International, Lalitpur, Nepal
| | - Achyut Raj Pandey
- Research, Evaluation and Innovation Department, HERD International, Lalitpur, Nepal
| | - Bikram Adhikari
- Research, Evaluation and Innovation Department, HERD International, Lalitpur, Nepal
| | - Grishu Shrestha
- Research, Evaluation and Innovation Department, HERD International, Lalitpur, Nepal
| | - Reecha Piya
- Research, Evaluation and Innovation Department, HERD International, Lalitpur, Nepal
| | - Bipul Lamichhane
- Research, Evaluation and Innovation Department, HERD International, Lalitpur, Nepal
| | - Shristi Garu
- Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Deepak Joshi
- Research, Evaluation and Innovation Department, HERD International, Lalitpur, Nepal
| | - Sushil Chandra Baral
- Research, Evaluation and Innovation Department, HERD International, Lalitpur, Nepal
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Skandro S, Abio A, Baernighausen T, Lowery Wilson M. Socio-demographic determinants of intimate partner violence in Angola: a cross-sectional study of nationally representative survey data. Arch Womens Ment Health 2024; 27:21-33. [PMID: 37816985 DOI: 10.1007/s00737-023-01376-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 05/15/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023]
Abstract
Intimate Partner Violence (IPV) is a global problem of public health importance, which can be found across all social layers and cultural backgrounds worldwide. Angola is still an under-explored country in the context of domestic violence and was therefore chosen as our focus of interest. Our study's goal was to identify the socio-demographic determinants of IPV in Angola. We used nationally representative data from female respondents of the 2015 Angolan Demographic and Health Surveys (DHS). Simple bivariate and multiple logistic regression analyses were used to assess the relationship between the experience of IPV and the women's' individual and contextual characteristics. Out of the 7,699 respondents, 3,070 (41.1%) reported having experienced at least one form of violence by their partners, with physical violence being more prevalent (32.5%) than emotional (27.7%) and sexual violence (7.2%). The partner's use of alcohol, the respondent's tendency to hurt her partner, her having witnessed her father beating her mother and being the first wife showed significantly higher odds of experiencing one or more types of IPV, whereas being older than the partner appears to have protective effects. Our findings reflect the widespread prevalence rates of violence against women in African countries. Future intervention programs should focus on women with risky background characteristics to help decrease domestic abuse in Angola. Our results indicate to focus on young women who have witnessed domestic violence in childhood, those whose partners use alcohol and those who tend to physically hurt their partners themselves. It is also recommended to intensify future research on the effects of co-wives on a relationship since first wives were found to have a higher risk of being physically abused by their partners.
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Affiliation(s)
- Simona Skandro
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Germany
| | - Anne Abio
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Germany
- Injury Epidemiology and Prevention, Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Till Baernighausen
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Germany
| | - Michael Lowery Wilson
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Germany.
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Amir-Ud-Din R, Idrees R, Farooqui J, Abbasi AS. Exploring spousal disparities: Age, earnings, and education as predictors of intimate partner violence in 29 developing countries. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241310289. [PMID: 39707898 DOI: 10.1177/17455057241310289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Academic Contribution Register] [Indexed: 12/23/2024]
Abstract
BACKGROUND Intimate partner violence (IPV) is widespread and is influenced by individual-specific factors. However, the impact of spousal sociodemographic disparities (age, earnings, education) remains understudied. OBJECTIVES This study investigates the relationship between spousal sociodemographic disparities and women's IPV experiences in 29 developing countries in South Asia, Sub-Saharan Africa, and the Middle East and North Africa. DESIGN We used a cross-sectional design, analyzing data from the Integrated Public Use Microdata Series-Demographic and Health Surveys (IPUMS-DHS). METHODS We conducted logistic regression to assess associations between spousal disparities and four forms of IPV including less severe physical violence (LSPV), severe physical violence (SPV), emotional violence (EV), and sexual violence (SV) based on spousal age, earnings, and education disparities. RESULTS The analysis revealed that spousal education disparities are significantly associated with increased IPV odds. Women with more educated husbands faced higher odds of LSPV (OR = 1.044, 95% CI = 1.01, 1.08; p < 0.05) and SV (OR = 1.085, 95% CI = 1.04, 1.14; p < 0.01), with no significant association for SPV or EV. Larger spousal age gaps were consistently associated with a reduced probability of all IPV forms, particularly LSPV (OR = 0.765, 95% CI = 0.72, 0.81; p < 0.001) and SV (OR = 0.656, 95% CI = 0.58, 0.74; p < 0.001). Earnings disparities also played a crucial role: women earning more than their husbands faced higher odds of LSPV (OR = 1.361, 95% CI = 1.23, 1.50; p < 0.001), EV (OR = 1.573, 95% CI = 1.42, 1.74; p < 0.001), and SV (OR = 1.624, 95% CI = 1.42, 1.86; p < 0.001). When husbands earned more, women also faced higher odds of IPV, although these associations were weaker. CONCLUSION The findings underscore the need for targeted policies to prevent IPV, particularly in low- and middle-income countries, by addressing spousal disparities in age, earnings, and education to promote gender equality.
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Affiliation(s)
- Rafi Amir-Ud-Din
- Department of Economics, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
| | - Rubina Idrees
- Department of Economics, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
| | - Javaria Farooqui
- Department of Humanities, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
| | - Abdus Sattar Abbasi
- Centre of Islamic Finance, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
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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] [Academic Contribution 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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Ahinkorah BO, Aboagye RG, Seidu AA, Boadu Frimpong J, Hagan JE, Budu E, Yaya S. Physical violence during pregnancy in sub-Saharan Africa: why it matters and who are most susceptible? BMJ Open 2023; 13:e059236. [PMID: 37369400 PMCID: PMC10410895 DOI: 10.1136/bmjopen-2021-059236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 11/11/2021] [Accepted: 03/20/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE The study assessed the prevalence of physical violence against pregnant women and its associated factors in sub-Saharan Africa (SSA). DESIGN We analysed cross-sectional data of 108971 women in sexual unions from the most recent Demographic and Health Surveys of 26 countries in SSA. The predictors of physical violence were examined using a multilevel binary logistic regression. All the results were presented as adjusted odds ratios (aORs) with their corresponding 95% confidence intervals (CIs). SETTING Twenty-six countries in SSA. PARTICIPANTS 108 971 women who had ever been pregnant. OUTCOME MEASURE Physical violence during pregnancy. RESULTS Physical violence was identified in 6.0% of pregnant women in SSA. The highest prevalence (14.0%) was reported in South Africa, while Burkina Faso recorded the lowest (2.1%). Women who had primary (aOR=1.26, 95% CI=1.15, 1.38) and secondary education (aOR=1.15, 95% CI=1.01,1.32); those who were cohabiting (aOR=1.21, 95% CI=1.11, 1.32); those who were working (aOR=1.17, 95% CI=1.08, 1.28); and those whose partners had primary (aOR=1.15, 95% CI=1.04, 1.28) and secondary education (aOR=1.14, 95% CI=1.01, 1.28) were more likely to experience physical violence during pregnancy compared with those who had no formal education; those who were married; those who were not working, and those whose partners had no formal education, respectively. Moreover, women whose partners consumed alcohol (aOR=2.37, 95% CI=2.20, 2.56); those who had parity of four or more (aOR=2.06, 95% CI=1.57, 2.72); and those who perceived intimate partner violence (IPV) as a culturally accepted norm (aOR=1.55, 95% CI=1.44, 1.67) had higher odds of experiencing physical violence during pregnancy compared to those whose partners did not consume alcohol, those with parity zero, and those who did not perceive IPV as culturally accepted, respectively. On the contrary, women who were aged 35-39, those who were of the richest wealth index, and those in rural areas had reduced odds of experiencing physical violence during pregnancy. CONCLUSION Based on the findings, community leaders are encouraged to liaise with law enforcement agencies to strictly enforce laws on gender-based violence by prosecuting perpetrators of IPV against pregnant women as a deterrent. Also, intensifying education on what constitutes IPV and the potential consequences on the health of pregnant women, their children, and their families will be laudable. Improving the socioeconomic status of women may also help to eliminate IPV perpetration against women at their pregnancy stage.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, 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, Queensland, Australia
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Muluneh MD, Francis L, Agho K, Stulz V. The Relationship Between Intimate Partner Violence and Unintended Pregnancy: Eastern Sub Saharan African Countries' Analysis of Demographic and Health Surveys. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5375-5403. [PMID: 36073139 DOI: 10.1177/08862605221120894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Academic Contribution Register] [Indexed: 06/15/2023]
Abstract
Intimate partner violence (IPV) adversely affects female reproductive health in various ways. Similarly, it plays a critical role in women's unintended pregnancy. This study examines the relationship between IPV and unintended pregnancy in Eastern Sub-Saharan Africa (SSA) countries. This study uses data from the nationally representative Demographic and Health Surveys (DHS) in six Eastern African SSA countries. The original sample size was restricted to ever married (or cohabitating) women of reproductive age who completed the survey's Domestic Violence Module and had a pregnancy in the previous 5 years. Svyset proportion was used to estimate the prevalence and 95% confidence intervals (CI) of the study outcomes and multiple logistic regression was used to compare outcomes of last pregnancy by exposure to lifetime IPV committed by the most recent partner. The prevalence of unintended pregnancy in Eastern SSA was 38% [36.4, 40.34] among married women with high disparity among countries. This prevalence was 45% [42.05, 48.15] and 55% [50.0, 59.87] among women who had experienced any form of IPV and sexual violence, respectively. After adjusting for potential confounding factors, women with a history of sexual violence had a higher risk of unintended pregnancy [AOR: 1.80, 95% CI: 1.39, 2.33] and increased odds of unintended pregnancy for women who had more than five living children [AOR: 4.93, 95% CI: 3.40, 7.15], women who lived in rural residences [AOR: 1.42, 95% CI: 1.07, 1.90], and women who reported they had financial barriers for health care [AOR: 1.36, 95% CI: 1.13, 1.64]. Our findings suggest that IPV, particularly sexual violence, is a key player for higher risk of unintended pregnancy in Eastern SSA countries. This study highlights the need for developing programs and implementation of policies that integrate sexual reproductive health and IPV to reduce unintended pregnancy among married and single women.
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Affiliation(s)
- Muluken Dessalegn Muluneh
- Amref Health Africa in Ethiopia, Addis Ababa, Ethiopia
- Western Sydney University, Parramatta South Campus
| | - Lyn Francis
- Western Sydney University, Parramatta South Campus
| | - Kingsley Agho
- Western Sydney University, NSW, Australia
- University of KwaZulu-Natal, Durban, South Africa
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Tsega NT, Belay DG, Aragaw FM, Asratie MH, Gashaw M, Endalew M. Magnitude and associated factors of intimate partner violence among youth women in Ethiopia: multilevel analysis based on 2016 Ethiopian Demographic and Health Survey. BMC Womens Health 2022; 22:549. [PMID: 36572908 PMCID: PMC9793678 DOI: 10.1186/s12905-022-02143-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 04/04/2022] [Accepted: 12/20/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The period of youth is important for the foundation of healthy and stable relationships, women's health and well-being. Youth women face a higher risk of experiencing violence than older women. Intimate partner violence (IPV) against youth women is a significant public health concern. Despite paramount negative health consequences of IPV for the survivor, as per our knowledge, research study on IPV and associated factors among youth women in Ethiopia is scarce. Therefore, this study aimed to assess the magnitude and associated factors of IPV among youth women in Ethiopia. METHODS The data was accessed from 2016 Ethiopia demographic and health survey (EDHS) which was a cross sectional population based household survey. It was also conducted using a multi-stage stratified random cluster sampling approach. The data were cleaned, weighted, and analyzed using STATA Version 14 software. The total weighted sample of 1077 youth women were used in this study. Multilevel logistic regression modeling was used to determine factors associated with IPV among youth women. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 were used to declare the significant variables. RESULTS Among the total participants, 30.27% (95% CI 27.59, 33.09) of youth women experienced IPV. Individual level variables such as: Being widowed/divorced/separated (AOR = 2.28; 95% CI 1.33, 3.91), having a partner who drinks alcohol (AOR = 5.76; 95% CI 3.42, 9.69), witnessing inter-parental violence during childhood (AOR = 3.45; 95% CI 2.21, 5.37), being afraid of partners (AOR = 7.09; 95% CI 4.30, 11.68), and from community level variables, youth women residing in communities with a low proportion of educated youth women (AOR = 0.31; 95% CI 0.13, 0.78) were significantly associated with having experience of IPV. CONCLUSION The magnitude of intimate partner violence among youth women in Ethiopia was relatively high as compared to the global estimate of IPV. Individual and community level variables such as currently widowed/divorced/separated women, having a partner who drinks alcohol, witnessing inter-parental violence, being afraid of partner, and women from a low proportion of community level youth women's education were significantly associated with intimate partner violence. To decrease this public health problem, it is better to strengthen legislation on the purchase and sale of alcohol, provide legal protection for separated/divorced women, establish effective legal response services for IPV, promote gender equality, and provide psychological support for those who witnessed inter-parental violence during childhood to reduce IPV.
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Affiliation(s)
- Nuhamin Tesfa Tsega
- grid.59547.3a0000 0000 8539 4635Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- grid.59547.3a0000 0000 8539 4635Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia ,grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- grid.59547.3a0000 0000 8539 4635Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Moges Gashaw
- grid.59547.3a0000 0000 8539 4635Department of Physiotherapy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mastewal Endalew
- grid.59547.3a0000 0000 8539 4635Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Partner alcohol consumption and intimate partner violence against women in sexual unions in sub-Saharan Africa. PLoS One 2022; 17:e0278196. [PMID: 36548221 PMCID: PMC9778561 DOI: 10.1371/journal.pone.0278196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 08/17/2021] [Accepted: 11/11/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Intimate partner violence is increasingly gaining attention as the leading form of violence against women globally, particularly sub-Saharan Africa. Given that substance abuse, especially alcohol consumption has long been associated with aggressive behaviour, emotional abuse, and sexual misconduct, it is surprising that studies on the potential association between partner's alcohol consumption and intimate partner violence are scarce. The current study seeks to fill this gap in the literature by examining the association between partner's alcohol consumption and intimate partner violence among women in sub-Saharan Africa. METHODS Cross-sectional survey data of 89,229 women aged 15 to 49 in sexual unions from 21 sub-Saharan African countries were pooled from the Demographic and Health Surveys. Percentages with their corresponding confidence intervals (CIs) were used to present the results of the prevalence of partner's alcohol consumption and intimate partner violence. Multivariable binary logistic regression analysis was used to examine the association between partner's alcohol consumption and intimate partner violence. The regression analysis results were presented using adjusted odds ratio (aOR) with 95% CI. Statistical significance was set at p<0.05. RESULTS The pooled prevalence of partner alcohol consumption was 36.3% [36.0-36.6]. The highest prevalence of partner alcohol consumption was found in Burundi (67.1%) with Mali (3.9%) recording the lowest prevalence. Similarly, the overall prevalence of physical violence, emotional violence, and sexual violence among the women were 19.7% [19.2-20.2], 25.0% [24.5-25.5], and 9.7% [9.3-10.1], respectively. In the pooled data, women whose partners consumed alcohol were more likely to experience physical violence [aOR = 2.37, 95% CI = 2.24-2.50], emotional violence [aOR = 1.96, 95% CI = 1.86-2.07], and sexual violence [aOR = 2.03, 95% CI = 1.89-2.18] compared to those whose partners did not consume alcohol. In all the 21 countries, women whose partners consumed alcohol had higher odds for physical and emotional violence. The odds of sexual violence was higher among women whose partners consumed alcohol compared to their counterparts whose partners did not in 20 countries, except Namibia. CONCLUSIONS We found that partner's alcohol consumption increases women's likelihood of experiencing physical, emotional, and sexual violence in sub-Saharan Africa. There is the need to implement behavioural change interventions targeted at male partners to reduce alcohol consumption. The findings call for the need to effectively create and organize support networks in addressing intimate partner violence among married and cohabiting women.
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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: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution 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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Tusa BS, Kebede SA, Weldesenbet AB. Spatial distribution and determinant factors of intimate partner violence among reproductive age group women in Ethiopia: Using generalized structural equation modeling. PLoS One 2022; 17:e0263811. [PMID: 35226676 PMCID: PMC8884698 DOI: 10.1371/journal.pone.0263811] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 10/17/2020] [Accepted: 01/27/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Intimate Partner Violence (IPV) is the most serious and pervasive yet under-recognized human rights violation in the world, particularly in Ethiopia. Hence, the objective of this study was to find the spatial distribution of IPV and its determinant factors in Ethiopia. METHODS Secondary data analysis was conducted among 2,687 reproductive age group women (15-49 years). The distribution of IPV across the country was observed by ArcGIS software. In SaTScan software, the Bernoulli model was fitted by Kulldorff methods to identify the purely spatial clusters of IPV. Besides, Generalized Structural Equation Model (GSEM) was used to determine factors associated with each domain of IPV (physical, emotional & sexual violence). RESULT The spatial distribution of IPV was found to be clustered in Ethiopia with Global Moran's I 0.09 (p < 0.001), and the highest IPV cluster was observed in Oromia (p < 0.001), Somali (p < 0.001) and SNNP (p<0.001) regions. Watching television and not having attitudes toward wife beating were negatively associated with physical violence. Being rich and nonsmoker were inversely associated with emotional violence. The odds of experiencing sexual violence were high among pregnant women and wives of uneducated husbands/partners. In addition, women's decision-making autonomy and husband/partner drinking alcohol have positive and negative associations with all domains of IPV respectively. CONCLUSION There was a significant clustering of IPV in Ethiopia and the highest IPV cluster was observed in Oromia, Somali and SNNP regions. Being rich, watching television, not having attitudes toward wife beating, women's decision-making autonomy, and husband's/partner's high education and non-alcohol drinker status were negatively associated with IPV. The likelihood of experiencing IPV was also high among smokers and pregnant women. Thus, we recommend that improving the economic status of the household through social protection and empowerment of women in decision-making autonomy by education and employment and increasing community awareness about the consequences of IPV with particular emphasis on Oromia, Somali and SNNP regions is essential.
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Affiliation(s)
- Biruk Shalmeno Tusa
- Department of Epidemiology and Biostatistics, Collage of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Sewnet Adem Kebede
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adisu Birhanu Weldesenbet
- Department of Epidemiology and Biostatistics, Collage of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
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Muluneh MD, Francis L, Agho K, Stulz V. A Systematic Review and Meta-Analysis of Associated Factors of Gender-Based Violence against Women in Sub-Saharan Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4407. [PMID: 33919171 PMCID: PMC8122481 DOI: 10.3390/ijerph18094407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Academic Contribution Register] [Received: 02/10/2021] [Revised: 03/23/2021] [Accepted: 04/15/2021] [Indexed: 11/22/2022]
Abstract
A systematic review and meta-analysis were employed to address the associated factors of gender-based violence (GBV) in sub-Saharan African (SSA) countries. The Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus and Web of Science were used to source articles with stringent eligibility criteria. A total of 4931 studies were found and 50 studies met the inclusion criteria. Pooled meta-analyses revealed that low educational attainment, higher alcohol consumption, substance use, history of child and family abuse, limited decision-making skills, experiencing depression, males having multiple sexual partners, and younger age were found to be individual- and family-associated factors that increase the experiences of GBV. Community tolerant attitudes to violence, women's unemployment, being Muslim, lower socioeconomic class, food and social insecurity were found to be community- and societal-associated factors of GBV. Alcohol consumption, low educational attainment, experiencing depression, being younger, a history of child and family abuse, tolerant attitudes to violence, and low socioeconomic status were poignant factors associated with GBV amongst women in SSA countries. The need to develop a multipronged approach of intervention is a top priority in SSA to reach the Sustainable Development Goals' (SDGs) target of 2030 to eliminate all forms of violence. Socio-behavioural change communication interventions at individual and community levels need to be introduced, and interventions need to address the prevention of child and family abuse and increase women's feelings of empowerment in order to prevent GBV in SSA.
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Affiliation(s)
- Muluken Dessalegn Muluneh
- School of Nursing and Midwifery, Parramatta South Campus, Western Sydney University, Sydney, NSW 2151, Australia;
- Amref Health Africa in Ethiopia, Addis Ababa P.O. Box 20855, Ethiopia
| | - Lyn Francis
- School of Nursing and Midwifery, Parramatta South Campus, Western Sydney University, Sydney, NSW 2151, Australia;
| | - Kingsley Agho
- School of Science and Health, Western Sydney University, Locked Bag 1797, Perth, NSW 2571, Australia;
- African Vision Research Institute (AVRI), University of KwaZulu-Natal, Durban 4041, South Africa
| | - Virginia Stulz
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia;
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Muluneh MD, Stulz V, Francis L, Agho K. Gender Based Violence against Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of Cross-Sectional Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E903. [PMID: 32024080 PMCID: PMC7037605 DOI: 10.3390/ijerph17030903] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Academic Contribution Register] [Received: 12/16/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 11/25/2022]
Abstract
This study aimed to systematically review studies that examined the prevalence of gender based violence (GBV) that included intimate partner violence (IPV) and non-IPV among women in sub-Saharan Africa (SSA). This evidence is an important aspect to work towards achieving the Sustainable Development Goals (SDG's) target of eliminating all forms of violence in SSA. The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus and Web of Science were used to source articles with stringent eligibility criteria. Studies on GBV in SSA countries that were published in English from 2008 to 2019 were included. A random effect meta-analysis was used. Fifty-eight studies met the inclusion criteria. The pooled prevalence of IPV among women was 44%, the past year-pooled prevalence of IPV was 35.5% and non-IPV pooled prevalence was 14%. The highest prevalence rates of IPV that were reported included emotional (29.40%), physical (25.87%) and sexual (18.75%) violence. The sub-regional analysis found that women residing in Western (30%) and Eastern (25%) African regions experienced higher levels of emotional violence. Integrated mitigation measures to reduce GBV in SSA should focus mainly on IPV in order to achieve the SDG's that will lead to sustainable changes in women's health.
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Affiliation(s)
- Muluken Dessalegn Muluneh
- School of Nursing and Midwifery, Western Sydney University, Parramatta South Campus, Parramatta, NSW 2151, Australia
- Amref Health Africa in Ethiopia, Addis Ababa 17022, Ethiopia
| | - Virginia Stulz
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Lyn Francis
- School of Nursing and Midwifery, Western Sydney University, Parramatta South Campus, Parramatta, NSW 2151, Australia
| | - Kingsley Agho
- School of Health Sciences, Western Sydney University, Locked Bag1797, Penrith, NSW 2571, Australia
- African Vision Research Institute (AVRI), University of KwaZulu-Natal, Durban 4041, South Africa
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Yaya S, Gunawardena N, Bishwajit G. Association between intimate partner violence and utilization of facility delivery services in Nigeria: a propensity score matching analysis. BMC Public Health 2019; 19:1131. [PMID: 31420028 PMCID: PMC6697943 DOI: 10.1186/s12889-019-7470-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 11/14/2018] [Accepted: 08/11/2019] [Indexed: 11/22/2022] Open
Abstract
Background Intimate partner violence (IPV) has been shown to be associated with poor maternal healthcare utilisation and poor pregnancy outcomes. IPV can be seen both as the cause and result of low socioeconomic status and lack of maternal autonomy that can limit women’s access to resources and motivation necessary for seeking healthcare during pregnancy. This paper aims to study the relationship between intimate partner violence (IPV) and the utilisation of facility delivery services in Nigeria. Methods We applied propensity score matching (PSM) approach to examine the relationship between intimate partner violence (IPV) and the utilisation of facility delivery services. PSM is a popular strategy for reducing sampling bias through balancing sample characteristics, a technique that mimics randomization on cross-sectional data. Data were collected from Nigeria DHS surveys conducted in 2008 and 2013. IPV was the main explanatory variable of interest for delivery at health facility which was defined as delivering at any health institution including health clinics. Results PSM generated 20,446 cases distributed into two equal groups i.e. those who delivered at health facility versus those who did not. The prevalence of facility delivery in 2013 was 56.8% (95%CI 55.0–58.6) indicating a moderate increase from its 2008 level of 43.2% (41.4–45.0%). Lifetime prevalence of emotional, physical and sexual abuse was respectively 21.5%(95%CI 20.6, 22.4), 14.9% (14.2, 15.7) and 5.0% (4.6–5.4). In the multivariable analysis after adjusting for potential confounders, ever experiencing emotional abuse was associated increased odds of not delivering at a health facility. (AOR = 1.228, 95%CI, 1.095–1.679). Conclusion Women experiencing emotional violence are less likely to use institutional delivery services, and hence are susceptible to increased risk of reproductive complications. IPV is a complex issue that needs to be tackled by introducing evidence based strategies contextually relevant to local sociocultural environment. Further studies are required to understand the roots of IPV and the pathways through which it hindrances healthcare utilisation among women.
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Affiliation(s)
- Sanni Yaya
- The George Institute, University of Oxford, Oxford, UK.
| | | | - Ghose Bishwajit
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
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