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Gunarathne L, Apputhurai P, Nedeljkovic M, Bhowmik J. Factors associated with married women's attitude toward intimate partner violence: A study on 20 low-and middle-income countries. Health Care Women Int 2024:1-21. [PMID: 38394302 DOI: 10.1080/07399332.2024.2319214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
Intimate Partner Violence (IPV) is a global problem and has been reported to be significantly higher for women in Low and Middle-Income Countries (LMICs). The researchers analyzed Demographic and Health Survey (DHS) data of married women in 20 LMICs to examine those most vulnerable to accepting IPV by investigating associated risk factors. The researchers revealed a higher level of acceptance of IPV among illiterate women from poorer households in remote areas. Using these findings, the authors provide insight into ensuring and enhancing the living standards of these vulnerable women by making education more readily accessible.
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Affiliation(s)
- Lakma Gunarathne
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Pragalathan Apputhurai
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Maja Nedeljkovic
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jahar Bhowmik
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Gunarathne L, Bhowmik J, Apputhurai P, Nedeljkovic M. Factors and consequences associated with intimate partner violence against women in low- and middle-income countries: A systematic review. PLoS One 2023; 18:e0293295. [PMID: 37939106 PMCID: PMC10631698 DOI: 10.1371/journal.pone.0293295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Intimate Partner Violence (IPV) is a global public health issue, with notably high prevalence rates observed within Low-and Middle-Income Countries (LMICs). This systematic review aimed to examine the risk factors and consequences associated with IPV against women in LMICs. Following PRISMA guidelines, we conducted a systematic review using three databases: Web of Science, ProQuest Central, and Scopus, covering the period from January 2010 to January 2022. The study included only peer-reviewed journal articles in English that investigated IPV against women in LMICs. Out of 167 articles screened, 30 met the inclusion criteria, comprising both quantitative and mixed-method studies. Risk factors of IPV were categorised as: demographic risk factors (23 studies), family risk factors (9 studies), community-level factors (1 studies), and behavioural risk factors (14 studies), while consequences of IPV were categorised as mental health impacts (13 studies), physical impacts (5 studies), and societal impacts (4 studies). In this study, several risk factors were identified including lower levels of education, marriage at a young age, poor wealth indices, rural residential areas, and acceptance of gender norms that contribute to the prevalence of IPV in LMICs. It is essential to address these factors through effective preventive policies and programs. Moreover, this review highlights the necessity of large-scale, high-quality policy-driven research to further examine risk factors and consequences, ultimately guiding the development of interventions aimed at preventing IPV against women in LMICs.
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Affiliation(s)
- Lakma Gunarathne
- Department of Health Science and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jahar Bhowmik
- Department of Health Science and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Pragalathan Apputhurai
- Department of Health Science and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Maja Nedeljkovic
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Castro Lopes S, Constant D, Fraga S, Harries J. How women's empowerment influences fertility-related outcomes and contraceptive practices: A cross-sectional study in Mozambique. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000670. [PMID: 36962719 PMCID: PMC10021614 DOI: 10.1371/journal.pgph.0000670] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 08/15/2022] [Indexed: 11/19/2022]
Abstract
Women's empowerment could be a crucial step for tackling gender inequality and improve women's reproductive health and rights in Mozambique. This study aims to examine how different domains of women's empowerment influence fertility-related outcomes and contraceptive practices in Mozambique. We used the 2015 Demographic Health Survey (DHS) conducted in Mozambique from which a sample of 2072 women aged 15 to 49 years were selected and included in this analysis. A principal component analysis was performed, and the components retained were identified as the domains of empowerment. These were: Beliefs about violence against women, Decision-making, and Control over sexuality and safe sex. A multinomial logistic regression was run to estimate the association between levels of empowerment for each domain and the study outcomes. Crude and adjusted odds ratio (OR) were calculated, with 95% confidence intervals (95% CI). Beliefs about violence against women and Control over sexuality and safe sex were positively associated with having 1 to 4 children. Control over sexuality and safe sex also increased likelihood of women wanting to space childbearing over more than 2 years. Decision-making increased the odds of women not wanting more children. Middle to high empowerment levels for Control over sexuality and safe sex also increased the chances of using any type of contraceptive method and using it for longer periods. All domains, from the middle to high levels of empowerment, decreased the chances of women not wanting to use contraception. Our study confirmed the multidimensional nature of empowerment showing that each domain had a different effect over specific fertility and contraceptive outcomes and reinforced the importance of a domain approach for estimating and understanding empowerment. It also revealed the critical role of Control over sexuality and safe sex domain for improving women's ability to decide over fertility and contraceptive practices in Mozambique.
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Affiliation(s)
- Sofia Castro Lopes
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Deborah Constant
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Sílvia Fraga
- EPIUnit–Institute of Public Health, University of Porto, Porto, Portugal
| | - Jane Harries
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Castro Lopes S, Constant D, Fraga S, Osman NB, Harries J. “There Are Things We Can Do and There Are Things We Cannot Do.” A Qualitative Study About Women's Perceptions on Empowerment in Relation to Fertility Intentions and Family Planning Practices in Mozambique. Front Glob Womens Health 2022; 3:824650. [PMID: 35400131 PMCID: PMC8983837 DOI: 10.3389/fgwh.2022.824650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe restrictive socio-cultural norms in Mozambique limit the power of women to decide, voice, and act on their reproductive choices. This study aimed to explore women's perceptions and experiences of empowerment relating to fertility intentions and family planning practices in Mozambique, focusing on facilitators and barriers toward reproductive empowerment.MethodsQualitative in-depth interviews were undertaken with women of reproductive age (18–49 years) in Nampula and Maputo provinces and Maputo city, Mozambique. Data collection took place between February and March 2020 in Maputo region and during August 2020 in Nampula Province. Convenience sampling was used to recruit participants from both urban and rural healthcare facilities and from within the communities serving the healthcare facilities. In Maputo city, a snowball sampling technique was used to recruit women from the community. A total of 64 women were interviewed, 39 from Maputo and 25 from Nampula. A thematic analysis was conducted with the support of NVivo12 software.ResultsSeveral factors that hinder and facilitate women's empowerment toward fertility and family planning practices in Mozambique were identified and were interpreted within the socio-ecological model. The identified barriers included women's lack of critical consciousness and oppressive relationships. At the community and societal levels, the role of traditions, culture and gender expectations and limited access to family planning and misinformation were also important hindering factors. The facilitators of reproductive empowerment included building critical consciousness and access to economic resources at the individual level. Negative experiences at the household level were triggers of women's empowerment for family planning. Building collective power and access to information, including education, were key at the community and societal levels.ConclusionsThis study identified various factors that positively or negatively influence women's empowerment journeys in Mozambique. The role of tradition, culture, and gender expectations, and oppressive relationships, were important barriers in both provinces. Women from rural areas would benefit from building of consciousness about their rights, and power to decide on their reproductive lives. Interactions with the health providers offer an opportunity to do this by favoring controlling behaviors concerning their reproductive lives, promoting social networking and levering collective power.
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Affiliation(s)
- Sofia Castro Lopes
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- *Correspondence: Sofia Castro Lopes
| | - Deborah Constant
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Sílvia Fraga
- Epidemiology Research Unit – Institute of Public Health, University of Porto, Porto, Portugal
| | - Nafissa Bique Osman
- Department of Gynaecology and Obstetrics, Faculty of Medicine, University Eduardo Mondlane, Maputo, Mozambique
| | - Jane Harries
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Castro Lopes S, Constant D, Fraga S, Bique Osman N, Correia D, Harries J. Socio-economic, demographic, and behavioural determinants of women's empowerment in Mozambique. PLoS One 2021; 16:e0252294. [PMID: 34048468 PMCID: PMC8162630 DOI: 10.1371/journal.pone.0252294] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 05/13/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Empowerment is considered pivotal for how women access and use health care services and experience their sexual and reproductive rights. In Mozambique, women’s empowerment requires a better understanding and contextualization, including looking at factors that could drive empowerment in that context. This study aims to identify socioeconomic, demographic, and behavioural determinants of different domains of women’s empowerment in Mozambique. Methods Using the Demographic and Health Survey (DHS) conducted in 2015 for Mozambique, a sample of 2072 women aged between 15 and 49 years old were included in this study. The DHS’s indicators of women’s empowerment were used in a principal component analysis and the obtained components were identified as the domains of empowerment. Logistic regressions were run to estimate the association of socioeconomic, demographic, and behavioural characteristics with each domain of empowerment. Crude and adjusted odds ratios (OR) and respective 95% confidence intervals (95% CI) were calculated. Results Three domains of women’s empowerment were identified, namely (1) Beliefs about violence against women, (2) Decision-making, and (3) Control over sexuality and safe sex. Region, rurality, the experience of intimate partner violence (IPV) and partner’s controlling behaviours were associated with Beliefs about violence against women, while Decision-making and Control over sexuality and safe sex were also associated with education, age and wealth. Employment, polygamous marriage and religion was positively associated with Decision-making, and access to media increased the odds of Control over sexuality and safe sex. Conclusion Women’s empowerment seems to be determined by different socio-economic, demographic, and behavioural factors and this seems to be closely related to different domains of empowerment identified. This finding affirms the multi-dimensionality of empowerment as well as the importance of considering the context- and community-specific characteristics.
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Affiliation(s)
- Sofia Castro Lopes
- Women’s Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- * E-mail:
| | - Deborah Constant
- Women’s Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Sílvia Fraga
- EPIUnit–Institute of Public Health, University of Porto, Porto, Portugal
| | - Nafissa Bique Osman
- Department of Gynaecology and Obstetrics, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Daniela Correia
- EPIUnit–Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jane Harries
- Women’s Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Khatiwada J, Muzembo BA, Wada K, Ikeda S. Dimensions of women's empowerment on access to skilled delivery services in Nepal. BMC Pregnancy Childbirth 2020; 20:622. [PMID: 33059624 PMCID: PMC7558736 DOI: 10.1186/s12884-020-03309-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 10/02/2020] [Indexed: 12/25/2022] Open
Abstract
Background Each day, approximately 810 women die during pregnancy and childbirth and 94% of the deaths take place in low and middle income countries. Only 45% of the births in South Asia are attended by skilled professionals, which is lower than that in other Asian regions. Antenatal and postnatal care received from skilled providers can help prevent maternal and neonatal mortality by identifying pregnancy-related complications. Women’s empowerment is considered to be a significant determinant of maternal health care outcomes; however, studies on the contextual influences of different dimensions of empowerment in Nepal are relatively limited. Therefore, this study analyzed nationwide survey data to examine the influence of women’s economic empowerment, sociocultural empowerment, familial/interpersonal empowerment and media and information technology empowerment on accessing skilled delivery services among the married women in Nepal. Methods This study examined the influence of women’s empowerment on skilled delivery services among married women (n = 4400) aged 15–49 years using data from the 2016 Nepal Demographic and Health Survey. Descriptive analysis and binary logistic regression analysis were employed to analyze the data. Results Significant associations were found between women’s media and information technology empowerment, economic empowerment and sociocultural empowerment and access to skilled birth attendants. Specifically, the education of women, their occupation, owning a bank account, media exposure, and internet use were significantly associated with the use of skilled birth attendants. Conclusion Focusing on women’s access to media and information technology, economic enhancement and education may increase the use of skilled birth attendants in Nepal.
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Affiliation(s)
- Januka Khatiwada
- Department of Public Health, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita City, Chiba, 286-8686, Japan.
| | - Basilua Andre Muzembo
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Koji Wada
- Department of Public Health, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita City, Chiba, 286-8686, Japan
| | - Shunya Ikeda
- Department of Public Health, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita City, Chiba, 286-8686, Japan
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SOCIAL DETERMINANTS OF HEALTH AFFECTING UTILIZATION OF MATERNAL HEALTH SERVICES IN AFRICA: A NARRATIVE REVIEW. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2020. [DOI: 10.33457/ijhsrp.688559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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