Individual and community-level risk factors of women's acceptance of intimate partner violence in Ethiopia: multilevel analysis of 2011 Ethiopian Demographic Health Survey

The spatial overlap between risk of intimate partner violence against women and suicide-related emergency calls

Intimate partner violence against women (IPVAW) is a global problem, and suicidal behaviour is one of its most serious consequences. However, no study has investigated the spatial overlap between the two. The aim of this paper is to analyse whether there is spatial overlap between IPVAW and suicide-related calls in the same neighbourhoods, and to identify common risk factors. Geocoded data on IPVAW (N = 2060) and suicide-related calls (N = 4916) from the city of Valencia, Spain, between 2019 and 2021 were collected from the 112 emergency service and the Spanish National Police Corps. We used two analytical approaches: (i) a Bayesian spatial Poisson regression modelling analysis to identify the risk factors associated with IPVAW and suicide-related calls; (ii) Bayesian joint spatial modelling to examine the common spatial distribution of these outcomes. Relative risk maps are also displayed and analysed. The study revealed a higher incidence of IPVAW and suicide-related calls in neighbourhoods with lower income and population density, and greater residential instability and immigrant concentration. There was a 70% similarity between high- and low-risk areas for these incidents, with a moderate positive correlation of 0.43. Notably, 98% of IPVAW risk variance was explained by shared factors, while 30% applied to suicide-related calls; high IPVAW risk was also found in peripheral areas, while suicide-related calls were concentrated in the city centre. The findings highlight the need to identify areas with shared risk and neighbourhood characteristics for the development of more effective intervention strategies.

Community Perspectives on Intimate Partner Violence During Pregnancy: A Qualitative Study from Rural Ethiopia

Intimate partner violence (IPV) during pregnancy is closely associated with adverse maternal and fetal outcomes. To develop prevention strategies and interventions, the exploration of cultural norms, societal attitudes, and perceptions related to IPV is vital. This study explored community perspectives on IPV during pregnancy in rural Ethiopia. We used an exploratory qualitative study design to collect data. Data were collected through in-depth interviews (IDIs) and focus group discussions (FGDs) guided by a semi-structured topic guide. The data were analyzed using a thematic analysis approach, revealing the following four themes: (1) threats to the health of the mother and the fetus; (2) the contributing factors of IPV during pregnancy; (3) coping strategies for IPV during pregnancy; and (4) the need for intervention. Supportive attitudes toward IPV, early marriage, lack of awareness among offenders about its consequences, alcohol use, poor couple communication, and provocation by wives were found to be the causes of IPV during pregnancy. Participants in this study perceived IPV as a normal and unavoidable aspect of marital relationships. Comprehensive interventions that address challenging the cultural norms that condone IPV, increase community awareness of its detrimental effects, improve couples' communication skills, and address alcohol abuse among men could play a crucial role in preventing or reducing IPV during pregnancy.

Help-seeking behaviors and determinant factors among women exposed to intimate partner violence in East Africa based on recent demographic and health survey data: a multilevel analysis

Introduction

Human rights violations and violence against women are serious public health issues that have numerous detrimental repercussions on one's physical, emotional, sexual, and reproductive health. According to studies, women's perceptions and traits of violence are highly predictive of their likelihood of seeking help against violence. Even though intimate partner violence is a huge challenge nowadays in Africa, there is a low level of help-seeking behavior. Conducting this study at the East African level on help-seeking behavior can provide a clue for policy-makers. Therefore, this study aimed to reveal the prevalence of help-seeking behavior against intimate partner violence and determinant factors among women in East Africa.

Method

Multilevel logistic regression analysis was carried out among East Africans using recent demographic and health survey data. A total of 7,387 participants aged 15 to 49 years were included in this study from East African countries. Individual- and community-level variables were considered to determine the associated factors with help-seeking behaviors against intimate partner violence with 95% CI and AOR.

Results

The prevalence of help-seeking behavior against intimate partner violence among women was 38.07% with 95% CI (36.96%, 39.18%). Husbands drink alcohol [AOR = 1.46: 95% CI (1.33, 1.61)], women who have work [AOR = 1.33: 95% CI (1.19, 1.50)], and women with higher educational status [AOR = 1.36: 95% CI (1.16, 1.59)] were factors associated with help-seeking behavior against intimate partner violence.

Conclusion

Approximately four out of 10 women were seeking help for intimate partner violence in East Africa. Husbands drinking alcohol, women's high educational status, and women having occupations were the factors that were associated with help-seeking behaviors against intimate partner violence.

Water, sanitation, and intimate partner violence: Insights from Kibra Slums, Nairobi

Background

Intimate partner violence (IPV) poses significant health and social challenges for women, particularly in slums characterised by limited access to basic amenities like water and sanitation facilities. This study aimed to investigate the association between accessibility of water, sanitation and hygiene (WASH) facilities and IPV among women in Kibra, Nairobi county, Kenya.

Methods

A cross-sectional study design utilising a modified Demographic Health and Survey questionnaire was conducted among women aged 15-49 in Kibra slums. Data on water and sanitation accessibility and IPV experiences were collected from 1068 participants. Quantitative analysis by use of logistic regression, was conducted to assess associations between WASH accessibility and IPV.

Results

Among the participants, 64.0% reported experiences of IPV. Women who had access to water inside household; adjusted odds ratio (AOR) = 0.44 (95% CI = 0.31-0.64) and sanitation AOR = 0.57 (95% CI = 0.37-0.88) had decreased odds of experiencing IPV whereas reliance on external water sources such as outside pipes AOR = 18.18 (95% CI = 8.62-38.33) or vendors AOR = 14.42 (95% CI = 6.88-30.24) had heightened IPV vulnerability.

Conclusions

Access to clean water and sanitation is associated with reduced likelihood of women experiencing IPV in slums whereas access to water outside household is associated with increased likelihood of experiencing IPV. Connecting households with water to improve access and construction of adequate sanitation facilities may protect women against intimate partner violence in slums.

Lived experiences of intimate partner violence survivors during pregnancy and who had spontaneous abortions: A phenomenological study to inform survivor-centered strategies

BACKGROUND

Previous studies quantified that women who experienced intimate partner violence (IPV) had a higher risk of spontaneous abortion than women who did not experience IPV. However, there is limited evidence documenting the experiences of women in Northern Ethiopia who have been subjected to partner violence and who had spontaneous abortions. This evidence is critical for policymakers looking to improve women's access to maternity care.

OBJECTIVES

This study aimed to explore the lived experiences of IPV survivors during pregnancy who had spontaneous abortions in Northern Ethiopia.

DESIGN

A phenomenological qualitative study design was used to explore the lived experiences of survivors of IPV who had spontaneous abortions.

METHODS

A total of 16 interviews were conducted between April 23 and June 5, 2020. Eight in-depth interviews and eight key informant interviews were conducted with eligible mothers who received the required service, Adigrat General Hospital service providers, zonal women's affairs experts, and legal professionals. The purposive sampling technique was used to select study participants, and the sample size was determined using the information saturation principle. The data were analyzed through open coding and thematic content analysis.

RESULT

The themes that emerged in this study included opinions toward IPV, mothers' and experts' experiences of partner support during pregnancy, attitudes toward IPV, and understanding of spontaneous abortion. Physical, emotional, sexual, and economic pressure were identified as the most common forms of IPV. Participants in the study believed that physical violence and stress were associated with spontaneous abortion. They also mentioned various strategies for preventing IPV, such as providing job opportunities for women, punishing perpetrators, and encouraging mutual tolerance.

CONCLUSION

This study found that spontaneous abortion is linked to any type of IPV, including physical IPV during pregnancy. IPV is a community-supported event that necessitates strategies and legal frameworks to prevent and mitigate its effects.

Climate Change, Extreme Weather, and Intimate Partner Violence in East African Agrarian-Based Economies

Severe weather events can be a catalyst for intimate partner violence, particularly in agricultural settings. This research explores the association between weather and violence in parts of East Africa that rely on subsistence farming. We used IPUMS-DHS data from Uganda in 2006, Zimbabwe in 2010, and Mozambique in 2011 for intimate partner violence frequency and EM-DAT data to identify weather events by region in the year of and year prior to IPUMS-DHS data collection. This work is grounded in a conceptual framework that illustrates the mechanisms through which violence increases. We used logistic regression to estimate the odds of reporting violence in regions with severe weather events. The odds of reporting violence were 25% greater in regions with severe weather compared to regions without in Uganda (OR = 1.25, 95% CI: 1.11-1.41), 38% greater in Zimbabwe (OR = 1.38, 95% CI: 1.13-1.70), and 91% greater in Mozambique (OR = 1.91, 95% CI: 1.64-2.23). Our results add to the growing body of evidence showing that extreme weather can increase women's and girls' vulnerability to violence. Moreover, this analysis demonstrates that climate justice and intimate partner violence must be addressed together.

Does Childhood Experience of Interparental Abuse Shape Women's Attitude Toward Intimate Partner Violence in Their Adult Life? Evidence From 31 Developing Countries

A significant amount of literature exists on the lasting effects of interparental abuse on children's psychological health as adults. However, evidence on how children's childhood experience of interparental violence shapes their attitude toward partner violence in adult intimate relationships is limited. Given the existing evidence that women's acceptance of partner violence as a social norm increases the risk of partner violence, we analyzed the effect of girls' witnessing interparental abuse (where a father is a perpetrator) on their attitude toward partner violence in their intimate relationships as adults. We used data from the Demographic and Health Surveys for 31 low and middle-income countries in Asia and Africa. Aggregating information about women's attitudes toward partner violence into a binary "intimate partner violence acceptance" variable, we found that a woman who witnessed her father beat her mother was 1.62 times more likely to justify partner violence than a woman who did not experience such interparental abuse (adjusted odds ratio [AOR] = 1.62, 95% CI [1.57, 1.66], p < .001). Additionally, using individual components of acceptance as response variables, we found that a woman who witnessed interparental abuse was significantly more likely to justify partner violence if she went out without telling her husband (OR = 1.49, 95% CI [1.45, 1.54], p < .001), neglected children (OR = 1.53, 95% CI [1.49, 1.58], p < .001), argued with the husband (OR = 1.49, 95% CI [1.45, 1.53], p < .001), refused sex with the husband (OR = 1.35, 95% CI [1.31, 1.39], p < .001), or burned food (OR = 1.36, 95% CI [1.31, 1.41], p < .001). This study highlights the need to put in place children-specific social policies to limit the intergenerational transmission of the adverse effects of intimate partner violence.

Multilevel analysis of factors for intimate partner violence during pregnancy in Gammo Goffa Zone, South Ethiopia: A community based study

Background

Intimate partner violence during pregnancy is a public health problem that can affect both maternal and fetal life. However, its prevalence and associated factors have not been well studied and understood in Ethiopia. Hence, this study was conducted to assess the individual and community-level factors associated with intimate partner violence during pregnancy in Gammo Goffa Zone, South Ethiopia.

Methods

A community-based cross-sectional study was conducted among 1,535 randomly selected pregnant women from July to October 2020. Data were collected using an interviewer-administered, standardized WHO multi-country study questionnaire and analyzed using STATA 14. A two level mixed-effects logistic regression model was used to identify factors associated with intimate partner violence during pregnancy.

Results

The prevalence of intimate partner violence during pregnancy was found to be 48% (95% CI: 45–50%). Factors affecting violence during pregnancy were identified at the community and individual levels. Access to health facilities (AOR = 0.61; 95% CI: 0.43, 0.85), women feeling isolated from the community (AOR= 1.96; 95% CI: 1.04, 3.69), and strict gender role differences (AOR= 1.45; 95% CI: 1.03, 2.04) were among higher-level factors found to be significantly associated with intimate partner violence during pregnancy. Low decision-making power was found to increase the odds of experiencing IPV during pregnancy (AOR= 2.51; 95% CI: 1.28, 4.92). Similarly, maternal education, maternal occupation, living with the partner's family, current pregnancy intended by the partner, dowry payment, and presence of marital conflict were among the individual- level factors found to increase the odds of experiencing intimate partner violence during pregnancy.

Conclusions

The prevalence of intimate partner violence during pregnancy was high in the study area. Both individual and community-level factors had significant implications on maternal health programs related to violence against women. Socio-demographic and socio-ecological characteristics were identified as associated factors. Since it is a multifaceted problem, special emphasis has to be given to multi-sectoral approaches involving all responsible bodies to mitigate the situation.

Prevalence and its predictors of intimate partner violence against pregnant women amid COVID-19 pandemic in Southwest Ethiopia, 2021: A cross-sectional study

OBJECTIVES

Preventive measures like staying-at-home and social distancing are among the top strategies on the list to avert the spread of coronavirus disease 2019 and its consequences. However, this strategy brings off another shadow pandemic of intimate partner violence against women, and no study has been done to assess the magnitude of intimate partner violence against pregnant women during the pandemic in Ethiopia. Therefore, this study was aimed to determine the prevalence of intimate partner violence and its predictors in Southwest Ethiopia amid the coronavirus disease 2019 pandemic.

METHODS

A community-based cross-sectional study was conducted, from 15 June 2021 to 15 August 2021, on a total of 590 pregnant women recruited by systematic random sampling techniques. Pretested structured questionnaires were used to collect data, and the data were entered using EpiData version 3.1 and analyzed by SPSS version 24. Logistic regression analysis was used to identify predictors of intimate partner violence. Finally, statistical significance was declared at a p-value <0.05.

RESULTS

The prevalence of intimate partner violence was 39.2%. Of this, 29.8%, 26.8%, and 22.2% of the pregnant women had experienced physical, sexual, and emotional intimate partner violence, respectively. Being illiterate (adjusted odds ratio = 2.36, 95% confidence interval: 1.33-4.19), having illiterate husbands (adjusted odds ratio = 4.79, 95% confidence interval: 2.69-8.55), household decisions made by the husband alone (adjusted odds ratio = 4.91, 95% confidence interval: 3.74-9.33), and pandemic-induced economic downturns (adjusted odds ratio = 9.03, 95% confidence interval: 5.18-15.98) were the predictors that were significantly associated with intimate partner violence.

CONCLUSION

The prevalence of intimate partner violence against pregnant women during the coronavirus disease 2019 pandemic has been found to be high in the study area. Thus, more efforts should be tried to integrating intimate partner violence screening in maternal and child healthcare services, and early identification of high-risk individuals, and continuous community-based awareness creation activities are recommended.