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Akinsulure-Smith AM, Andjembe Etogho EB, Genco SH. Exploring the Role of Traditional Women Society Membership Among West African Immigrant Women Who Have Experienced Female Genital Mutilation/Cutting. Violence Against Women 2023:10778012231181046. [PMID: 37350152 DOI: 10.1177/10778012231181046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
This study explores the complex nature of female genital mutilation/cutting (FGM/C) by juxtaposing the mental and sexual health of women who had undergone FGM/C as part of initiation/membership into a traditional women's society (TWS) with those who were also cut but not initiated into a TWS. While considerable differences emerged between TWS members and nonmembers, there was no evidence that TWS membership was protective against the physical and psychological trauma typically ascribed to FGM/C. In fact, the pattern of results would tend to suggest the opposite. Possible explanations for and implications of these findings are discussed.
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Affiliation(s)
| | | | - Simge Huyal Genco
- Department of Psychology, The City College of New York, New York, NY, USA
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2
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Howard JA, Gibson MA. No relationship found between female genital cutting and intimate partner violence across six sub-Saharan African countries. Glob Public Health 2022; 17:2704-2719. [PMID: 34743651 DOI: 10.1080/17441692.2021.1991974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Female genital cutting (FGC) and intimate partner violence (IPV) are highly prevalent forms of violence against women, and the UN has encouraged strengthening policy linkages between FGC and IPV programme work (UN Women, Female genital mutilation/cutting and violence against women and girls. Strengthening the policy linkages between different forms of violence. UN Women, 2017a). However few studies have examined the relationship between these behaviours. This study addresses two research gaps identified by the UN; (a) whether women with FGC are more likely to experience physical or sexual IPV, and (b) whether women's IPV experiences are associated with their support for FGC. Multilevel multivariate logistic regression models were run using Demographic and Health Survey data from 6 sub-Saharan African countries (Burkina Faso, Ethiopia, The Gambia, Ivory Coast, Kenya and Nigeria, n33,170). Our results show no association between FGC and IPV. Women with FGC are not at greater risk of experiencing IPV, and women who experienced IPV in the preceding year are not more likely to support FGC. Further, the importance of individual and community factors differ; IPV experience is influenced by individual factors, whereas FGC support is more influenced by ethnic group characteristics. Although the proposition that FGC and IPV could be tackled collaboratively is attractive for policy makers, these results are important because they indicate that eradication programmes will be more effective when targeted at specific behaviours.
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Affiliation(s)
- Janet A Howard
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK
| | - Mhairi A Gibson
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK
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3
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Hayes BE, van Baak C. Intimate Partner Violence and Age at Marriage in Mali: The Moderating Influence of Polygynous Unions. Violence Against Women 2022; 29:1319-1342. [PMID: 35971564 DOI: 10.1177/10778012221108418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Polygyny and early marriage - both prevalent in Mali - are risk factors for intimate partner violence (IPV). Relying on data from the 2018 Malian Demographic and Health Surveys, the study examines the effects of polygyny and age at marriage, while controlling for known risk factors of IPV, on the likelihood of experiencing IPV. Findings reveal that polygyny is associated with IPV. However, polygyny has a moderating influence on the association between age at marriage and the experience of physical abuse and controlling behavior. The complex nature of women's experiences and the need for culturally specific programming are reviewed.
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Affiliation(s)
- Brittany E Hayes
- School of Criminal Justice, 2514University of Cincinnati, Cincinnati, OH, USA
| | - Carlijn van Baak
- Netherlands Institute for the Study of Crime and Law Enforcement (NSCR), The Netherlands.,Department of Sociology, 1234University of Amsterdam, Amsterdam, The Netherlands
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4
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Coll CVN, Santos TM, Wendt A, Hellwig F, Ewerling F, Barros AJD. Women's Empowerment as It Relates to Attitudes Towards and Practice of Female Genital Mutilation/Cutting of Daughters: An Ecological Analysis of Demographic and Health Surveys From 12 African Countries. FRONTIERS IN SOCIOLOGY 2022; 6:685329. [PMID: 35155663 PMCID: PMC8826721 DOI: 10.3389/fsoc.2021.685329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Background: Women's empowerment may play a role in shaping attitudes towards female genital mutilation/cutting (FGM/C) practices. We aimed to investigate how empowerment may affect women's intention to perpetuate FGM/C and the practice of FGM/C on their daughters in African countries. Materials and methods: We used data from Demographic and Health Surveys carried out from 2010 to 2018. The countries included in our study were Benin, Burkina Faso, Chad, Côte d´Ivoire, Ethiopia, Guinea, Kenya, Mali, Nigeria, Senegal, Tanzania, and Togo. This study included 77,191 women aged 15-49 years with at least one daughter between zero and 14 years of age. The proportion of women who reported having at least one daughter who had undergone FGM/C as well as the mother's opinion towards FGM/C continuation were stratified by empowerment levels in three different domains (decision-making, attitude to violence, and social independence) for each country. We also performed double stratification to investigate how the interaction between both indicators would affect daughter's FGM/C. Results: The prevalence of women who had at least one daughter who had undergone FGM/C was consistently higher among low empowered women. Tanzania, Benin, and Togo were exceptions for which no differences in having at least one daughter subjected to FGM/C was found for any of the three domains of women's empowerment. In most countries, the double stratification pointed to a lower proportion of daughters' FGM/C among women who reported being opposed to the continuation of FGM/C and had a high empowerment level while a higher proportion was observed among women who reported being in favor of the continuation of FGM/C and had a low empowerment level. This pattern was particularly evident for the social independence domain of empowerment. In a few countries, however, a higher empowerment level coupled to a favorable opinion towards FGM/C was related to a higher proportion of daughters' FGM/C. Conclusion: Women's empowerment and opinion towards FGM/C seems to be important factors related to the practice of FGM/C in daughters. Strategies to improve women's empowerment combined with shifts in the wider norms that support FGM/C may be important for achieving significant reductions in the practice.
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Affiliation(s)
- Carolina V. N. Coll
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Thiago M. Santos
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Andrea Wendt
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Franciele Hellwig
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Fernanda Ewerling
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Aluisio J. D. Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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5
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Ameyaw EK, Anjorin S, Ahinkorah BO, Seidu AA, Uthman OA, Keetile M, Yaya S. Women's empowerment and female genital mutilation intention for daughters in Sierra Leone: a multilevel analysis. BMC WOMENS HEALTH 2021; 21:200. [PMID: 33985466 PMCID: PMC8120903 DOI: 10.1186/s12905-021-01340-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/04/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Female genital mutilation is common in Sierra Leone. Evidence indicates that empowering women provides protective benefits against female genital mutilation/cutting (FGM/C). Yet, the relationship between women's empowerment and their intention to cut their daughters has not been explored in Sierra Leone. The aim of this study was to assess the association between women's empowerment and their intention to have their daughters undergo FGM/C in the country. METHODS Data for this study are from the 2013 Sierra Leone Demographic and Health Survey. A total of 7,706 women between the ages of 15 and 49 were included in the analysis. Analysis entailed generation of descriptive statistics (frequencies and percentages), and estimation of multi-level logistic regression models to examine the association between women's empowerment, contextual factors and their intentions to cut their daughters. RESULTS A significantly higher proportion of women who participated in labour force reported that they intended to cut their daughters compared to those who did not (91.2%, CI = 90.4-91.9 and 86.0%, CI = 84.1-87.8, respectively). Similarly, the proportion intending to cut their daughters was significantly higher among women who accepted wife beating than among those who rejected the practice (94.9%, CI = 93.8-95.8 and 86.4% CI = 84.9-87.8, respectively). A significantly higher proportion of women with low decision-making power intended to cut their daughters compared to those with high decision-making power (91.0%, CI = 89.0-92.8 and 85.0% CI = 82.2-87.4, respectively). Results from multivariate regression analysis showed that the odds of intending to cut daughters were significantly higher among women who participated in labour force (aOR = 2.5, CI = 1.3-4.7) and those who accepted wife beating than among those who did not (aOR = 2.7, CI = 1.7-4.5). In contrast, the likelihood of intending to cut daughters was significantly lower among women with high than low knowledge (aOR = 0.4, CI = 0.3-0.7), and among those aged 45-49 than among those aged 15-19 (aOR = 0.2, CI = 0.0-0.6). CONCLUSION The findings underscore the need to align anti-FGM/C policies and programmes to women who have undergone FGM/C, those with low knowledge, women who support wife beating and young women. Such interventions could highlight the adverse implications of the practice by stressing the psychological, health and social implications of FGM/C on its survivors.
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Affiliation(s)
- Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Seun Anjorin
- Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.,College of Public Health, Medical and Veterinary Services, James Cook University, Douglas, Australia
| | - Olalekan A Uthman
- Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Mpho Keetile
- Population Studies and Demography, University of Botswana, Gaborone, Botswana
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
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Tarzia L, Hegarty K. A conceptual re-evaluation of reproductive coercion: centring intent, fear and control. Reprod Health 2021; 18:87. [PMID: 33906687 PMCID: PMC8077849 DOI: 10.1186/s12978-021-01143-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reproductive coercion and abuse (RCA) is a hidden form of violence against women. It includes behaviours intended to control or dictate a woman's reproductive autonomy, for the purpose of either preventing or promoting pregnancy. MAIN TEXT In this commentary, we argue that there is a lack of conceptual clarity around RCA that is a barrier to developing a robust evidence base. Furthermore, we suggest that there is a poor understanding of the way that RCA intersects with other types of violence (intimate partner violence; sexual violence) and-as a result-inconsistent definition and measurement in research and healthcare practice. To address this, we propose a new way of understanding RCA that centres perpetrator intent and the presence of fear and/or control. Recommendations for future research are also discussed. CONCLUSION We suggest that IPV and SV are the mechanisms through which RCA is perpetrated. In other words, RCA cannot exist without some other form of co-occurring violence in a relationship. This has important implications for research, policy and healthcare practice including for screening and identification of women in reproductive healthcare settings.
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Affiliation(s)
- Laura Tarzia
- Department of General Practice, The University of Melbourne, Level 2, 780 Elizabeth Street, Melbourne, VIC, 3010, Australia.
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, VIC, Australia.
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Level 2, 780 Elizabeth Street, Melbourne, VIC, 3010, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, VIC, Australia
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7
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Human rights during the COVID-19 pandemic: the issue of female genital mutilations. Public Health 2020; 185:53-54. [PMID: 32563099 PMCID: PMC7247461 DOI: 10.1016/j.puhe.2020.05.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 12/04/2022]
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Bellizzi S, Say L, Rashidian A, Boulvain M, Abdulcadir J. Is female genital mutilation associated with eclampsia? Evidence from a nationally representative survey data. Reprod Health 2020; 17:68. [PMID: 32434579 PMCID: PMC7238645 DOI: 10.1186/s12978-020-00918-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 05/11/2020] [Indexed: 11/15/2022] Open
Abstract
Background Studies have shown the impact of female genital mutilation (FGM), especially infibulation (WHO type III), on reproductive health, and adverse obstetric outcomes like postpartum haemorrhage and obstructed labour. However, whether an association exists with maternal hypertensive complication is not known. The present study sought to investigate the role of the different types of FGM on the occurrence of eclampsia. Methods The study used data from the 2006 Demographic and health survey of Mali. The proportion of eclampsia in women with each type of FGM and the unadjusted and adjusted odds ratios (OR) were calculated, using women without FGM as reference group. Unadjusted and adjusted OR were also calculated for women who underwent infibulation compared to the rest of the population under study (women without FGM and women with FGM type I, II, and IV). Results In the 3997 women included, the prevalence of infibulation was 10.2% (n = 407) while 331 women did not report FGM (8.3%). The proportion of women reporting signs and symptoms suggestive of eclampsia was 5.9% (n = 234). Compared with the absence of female genital mutilation and adjusted for covariates, infibulation was associated with eclampsia (aOR 2.5; 95% CI:1.4–4.6), while the association was not significant in women with other categories of FGM. A similar aOR was found when comparing women with infibulation with the pooled sample of women without FGM and women with the other forms of FGM. Conclusion The present study suggests a possible association between infibulation and eclampsia. Future studies could investigate this association in other settings. If these findings are confirmed, the possible biological mechanisms and preventive strategies should be investigated.
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Affiliation(s)
- Saverio Bellizzi
- Partnership for Maternal, Newborn and Child Health, Geneva, Switzerland.
| | - Lale Say
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Arash Rashidian
- Department of Information, Evidence and Research, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Michel Boulvain
- Department of woman, child and adolescent. Division of Gynecology, Geneva University Hospitals, Geneva, Switzerland
| | - Jasmine Abdulcadir
- Department of woman, child and adolescent. Division of Gynecology, Geneva University Hospitals, Geneva, Switzerland
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9
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Female genital mutilation in Africa: Scoping the landscape of evidence. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2019.100189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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10
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Drew LB, Mittal M, Thoma ME, Harper CC, Steinberg JR. Intimate Partner Violence and Effectiveness Level of Contraceptive Selection Post-Abortion. J Womens Health (Larchmt) 2019; 29:1142-1149. [PMID: 31721639 DOI: 10.1089/jwh.2018.7612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: We examined whether experiencing more types of lifetime intimate partner violence (IPV) was independently associated with the effectiveness level of the contraceptive method women chose following an abortion. Materials and Methods: Using data on 245 women who were attending an urban hospital abortion clinic, we assessed whether women had ever experienced emotional, physical, or sexual IPV. Effectiveness of women's post-abortion contraceptive method selection was categorized into high (intrauterine device [IUD] and implant), moderate (pill, patch, ring, and shot), and low (condoms, emergency contraception, and none) effectiveness. Using multinomial logistic regression, we examined the relationship between number of types of IPV experienced and post-abortion contraceptive method effectiveness, adjusting for sociodemographics, prior abortion, having children, abortion trimester, importance of avoiding pregnancy in the next year, pre-abortion psychological distress, and effectiveness level of the contraceptive method women were planning to use before contraceptive counseling. Results: Twenty-seven percent (27%) of women experienced two or three types of IPV, 35% experienced one IPV type, and 38% experienced no IPV. Compared to women with no histories of IPV, women who experienced two or more types of IPV during their lifetimes were more likely to choose contraceptive methods with moderate effectiveness (adjusted odds ratio [AOR] = 5.23, 95% confidence interval [CI]: 1.13-24.23, p = 0.035) and high effectiveness (AOR = 5.01, 95% CI: 1.12-22.39, p = 0.035) than those with low effectiveness. Conclusion: Women who experienced two or more types of lifetime IPV selected more effective contraceptive methods post-abortion. Access to contraceptives that are not partner dependent, including long-acting reversible contraceptives (LARC), may be particularly important for women who have experienced multiple types of IPV.
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Affiliation(s)
- Laura B Drew
- Department of Family Science, School of Public Health, University of Maryland College Park, College Park, Maryland, USA
| | - Mona Mittal
- Department of Family Science, School of Public Health, University of Maryland College Park, College Park, Maryland, USA
| | - Marie E Thoma
- Department of Family Science, School of Public Health, University of Maryland College Park, College Park, Maryland, USA
| | - Cynthia C Harper
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA
| | - Julia R Steinberg
- Department of Family Science, School of Public Health, University of Maryland College Park, College Park, Maryland, USA
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Grose RG, Hayford SR, Cheong YF, Garver S, Kandala NB, Yount KM. Community Influences on Female Genital Mutilation/Cutting in Kenya: Norms, Opportunities, and Ethnic Diversity. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2019; 60:84-100. [PMID: 30614273 PMCID: PMC7890576 DOI: 10.1177/0022146518821870] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Female genital mutilation/cutting (FGMC) is a human rights violation with adverse health consequences. Although prevalence is declining, the practice persists in many countries, and the individual and contextual risk factors associated with FGMC remain poorly understood. We propose an integrated theory about contextual factors and test it using multilevel discrete-time hazard models in a nationally representative sample of 7,535 women with daughters who participated in the 2014 Kenya Demographic and Health Survey. A daughter's adjusted hazard of FGMC was lower if she had an uncut mother who disfavored FGMC, lived in a community that was more opposed to FGMC, and lived in a more ethnically diverse community. Unexpectedly, a daughter's adjusted FGMC hazard was higher if she lived in a community with more extrafamilial opportunities for women. Other measures of women's opportunities warrant consideration, and interventions to shift FGMC norms in more ethnically diverse communities show promise to accelerate abandonment.
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12
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Hayes BE, van Baak C. Risk Factors of Physical and Sexual Abuse for Women in Mali: Findings From a Nationally Representative Sample. Violence Against Women 2016; 23:1361-1381. [PMID: 27495783 DOI: 10.1177/1077801216658979] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mali is a developing country that has marked inequalities between genders. Using the 2012-2013 Mali Demographic and Health Survey, a nationally representative sample of Malian women ( N = 2,527), the study examined the effect of controlling behaviors, childhood exposure to and experience of violence, husband's alcohol use, woman's use of violence, and sociocultural factors on the likelihood of experiencing physical and sexual abuse. Findings indicated that controlling behavior, childhood exposure to violence, and husband's use of alcohol were predictors of physical and sexual abuse. Respondent's use of violence increased risk of physical abuse. Implications for programming in Mali are discussed.
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13
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Varol N, Fraser IS, Ng CHM, Jaldesa G, Hall J. Female genital mutilation/cutting--towards abandonment of a harmful cultural practice. Aust N Z J Obstet Gynaecol 2014; 54:400-5. [PMID: 24801568 DOI: 10.1111/ajo.12206] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 03/03/2014] [Indexed: 11/28/2022]
Abstract
Globally, the prevalence of, and support for, female genital mutilation/cutting (FGM/C) is declining. However, the entrenched sense of social obligation that propagates the continuation of this practice and the lack of open communication between men and women on this sensitive issue are two important barriers to abandonment. There is limited evidence on the role of men and their experiences in FGM/C. Marriageability of girls is considered to be one of the main driving forces for the continuation of this practice. In some countries, more men than women are advocating to end FGM/C. Moreover, men, as partners to women with FGM/C, also report physical and psychosexual problems. The abandonment process involves expanding a range of successful programs, addressing the human rights priorities of communities and providing power over their own development processes. Anecdotal evidence exists that FGM/C is practised amongst African migrant populations in Australia. The Australian Government supports a taskforce to improve community awareness and education, workforce training and evidence building. Internationally, an African Coordinating Centre for abandonment of FGM/C has been established in Kenya with a major global support group to share research, promote solidarity, advocacy and implement a coordinated and integrated response to abandon FGM/C.
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Affiliation(s)
- Nesrin Varol
- Queen Elizabeth II Research Institute for Mothers and Infants, University of Sydney, Sydney, Australia; Royal Prince Alfred Hospital, Sydney, Australia
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14
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Peltzer K, Pengpid S. Female genital mutilation and intimate partner violence in the Ivory Coast. BMC WOMENS HEALTH 2014; 14:13. [PMID: 24451017 PMCID: PMC3900257 DOI: 10.1186/1472-6874-14-13] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 01/22/2014] [Indexed: 11/10/2022]
Abstract
Background Serious forms of violence against women include Female Genital Mutilation (FGM) and Intimate Partner Violence (IPV). The aim of this study was to determine if FGM is associated with IPV, using data obtained from the Demographic and Health Survey (DHS) 2012 in Ivory Coast. Methods Participants for this study were drawn from the 2011-12 Ivory Coast Demographic and Health Survey (CDHS), a nationally representative sample of 10060 women aged 15 to 49 years. The analysis of this paper is restricted to the sample of women who responded to the FGM and domestic violence modules (N = 5005). Results The lifetime prevalence of physical violence was 24.8%, sexual violence, 5.7%, and emotional violence, 19.0%, and the prevalence of any lifetime IPV was 32.1%. In all, 40.6% reported female genital cutting or mutilation (FGM). Women reporting FGM were two times as likely to experience sexual IPV (AOR: 1.96, CI: 1.29-2.98), while other subtypes of IPV were higher in women reporting FGM but they were not significant. Of the socio-demographic covariates, urban residence and having a primary education were associated with most subtypes of IPV, while being a Muslim seemed protective from any type, sexual and emotional IPV. Having seen the father beating the mother was positively associated with most IPV subtypes, and having been diagnosed with a sexually transmitted infection (STI) in the previous 12 months was associated with physical and sexual IPV. Conclusion Significant rates of FGM and IPV were found among this sample of Ivorian women calling for the need for multiple strategies to reduce FGM and IPV.
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Affiliation(s)
- Karl Peltzer
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon 73170, Thailand.
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15
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Gupta J, Falb KL, Lehmann H, Kpebo D, Xuan Z, Hossain M, Zimmerman C, Watts C, Annan J. Gender norms and economic empowerment intervention to reduce intimate partner violence against women in rural Côte d'Ivoire: a randomized controlled pilot study. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2013; 13:46. [PMID: 24176132 PMCID: PMC3816202 DOI: 10.1186/1472-698x-13-46] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 10/24/2013] [Indexed: 11/12/2022]
Abstract
Background Gender-based violence against women, including intimate partner violence (IPV), is a pervasive health and human rights concern. However, relatively little intervention research has been conducted on how to reduce IPV in settings impacted by conflict. The current study reports on the evaluation of the incremental impact of adding “gender dialogue groups” to an economic empowerment group savings program on levels of IPV. This study took place in north and northwestern rural Côte d’Ivoire. Methods Between 2010 and 2012, we conducted a two-armed, non-blinded randomized-controlled trial (RCT) comparing group savings only (control) to “gender dialogue groups” added to group savings (treatment). The gender dialogue group consisted of eight sessions that targeted women and their male partner. Eligible Ivorian women (18+ years, no prior experience with group savings) were invited to participate. 934 out of 981 (95.2%) partnered women completed baseline and endline data collection. The primary trial outcome measure was an overall measure of past-year physical and/or sexual IPV. Past year physical IPV, sexual IPV, and economic abuse were also separately assessed, as were attitudes towards justification of wife beating and a woman’s ability to refuse sex with her husband. Results Intent to treat analyses revealed that compared to groups savings alone, the addition of gender dialogue groups resulted in a slightly lower odds of reporting past year physical and/or sexual IPV (OR: 0.92; 95% CI: 0.58, 1.47; not statistically significant). Reductions in reporting of physical IPV and sexual IPV were also observed (not statistically significant). Women in the treatment group were significantly less likely to report economic abuse than control group counterparts (OR = 0.39; 95% CI: 0.25, 0.60, p < .0001). Acceptance of wife beating was significantly reduced among the treatment group (β = -0.97; 95% CI: -1.67, -0.28, p = 0.006), while attitudes towards refusal of sex did not significantly change Per protocol analysis suggests that compared to control women, treatment women attending more than 75% of intervention sessions with their male partner were less likely to report physical IPV (a OR: 0.45; 95% CI: 0.21, 0.94; p = .04) and report fewer justifications for wife beating (adjusted β = -1.14; 95% CI: -2.01, -0.28, p = 0.01) ; and both low and high adherent women reported significantly decreased economic abuse (a OR: 0.31; 95% CI: 0.18, 0.52, p < 0.0001; a OR: 0.47; 95% CI: 0.27, 0.81, p = 01, respectively). No significant reductions were observed for physical and/or sexual IPV, or sexual IPV alone. Conclusions Results from this pilot RCT suggest the importance of addressing household gender inequities alongside economic programming, because this type of combined intervention has potential to reduce levels of IPV. Additional large-scale intervention research is needed to replicate these findings. Trial registration Registration Number: NCT01629472.
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Affiliation(s)
- Jhumka Gupta
- Department of Chronic Disease Epidemiology, Division of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06520, USA.
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