Adapted tool for the assessment of domestic violence against women in a low-income country setting: a reliability analysis

Inequitable gender norms and its associated factors among university students in southern Ethiopia: a cross-sectional study, 2022

Background

Gender defined as the socially constructed roles, behaviors, activities, and characteristics that society deems appropriate for men, women, and other gender identities. Inequitable gender norms promote male dominance and aggressiveness while portraying women as being subservient. Ensuring equitable gender norms is a prerequisite for achieving gender equality in a society. The rise in maternal mortality and morbidity, adolescent pregnancies, unwanted pregnancies, unsafe abortions, HIV/AIDS, gender-based violence, and obstacles to reproductive health care are all linked to inequitable gender norms. On the other hand, not much is known regarding inequitable gender norms and their correlation in our setting.

Objective

The purpose of this study was to evaluate university students' attitudes regarding inequitable gender norms and responsible factors.

Design

Between October 25 and November 10, 2022, students from Jinka and Arba Minch University participated in an institution-based cross-sectional study.

Methods

A total of 635 students were selected using a multi-stage sampling technique. The Gender Equitable Men Scale was employed to evaluate inequitable gender norms. Data were verified and entered into Epi-Data Version 3.1, then analyzed using SPSS Version 25.0. Binary logistic regression was initially used to identify potential factors associated with inequitable gender norms, variables having a p-value <0.25 in bivariate analysis considered for multivariable regression. The final model's fit was assessed using the Hosmer-Lemeshow goodness-of-fit statistic, confirming its adequacy. Statistical significance was determined at a threshold of p < 0.05.

Results

Of the study participants, 44.1% (95% CI: 40.10, 48.10%) had an inequitable gender norm, while the mean score for a inequitable gender norm was 61.4 (SD 8.4). Inequitable gender norm was associated with sex being male (AOR = 1.75, 95%CI: 1.19, 2.56), romantic relationship breakup (AOR = 2.10, 95% CI: 1.14, 3.99), and having a negative attitude toward gender equality (AOR = 3,14, 95% CI: 2.15, 4.58).

Conclusion

A notable number of participants expressed support for inequitable gender norms. This underscores the importance of comprehensive efforts by relevant stakeholders to address identified factors and promote equitable gender norms among university students.

Intimate partner violence against women among contraceptive users at a primary health care setting in Southern Ethiopia: a facility-based cross-sectional study

BACKGROUND

One in three women experienced intimate partner violence (IPV) worldwide which has remained major public health challenge. Women's reproductive health service utilization has been seriously impacted by IPV. There is a paucity of evidence on the magnitude of IPV among contraceptive users in southern Ethiopia. Hence, the main aim of this study was to determine the level of IPV and its associated factors among married women who were contraceptive users in primary health care settings in Adilo Zuria district in southern Ethiopia.

METHODS

A facility-based cross-sectional study was conducted among systematically recruited 405 married women who were contraceptive users in a primary health care setting in Adilo Zuria district in southern Ethiopia. Data were collected through face-to-face interviews using an adapted tool from existing literature including the World Health Organization IPV survey. Collected data were entered into EpiData 4.6 and exported to SPSS version 26 for cleaning and analysis. Descriptive and logistic regression analyses were performed to determine the level of IPV and identify factors associated with IPV. An adjusted odds ratio (AOR) from multiple logistic regression at a 95% confidence interval (CI) was used to declare a significant association.

RESULTS

The prevalence of current IPV among contraceptive users was 72.6% (95% CI; 68.1-76.8%). Current psychological, physical, and sexual violence were 39.3%, 38.5%, and 31.9%, respectively. In multivariable analysis, women's being rural resident (AOR: 3.19, 95%CI: 1.69-6.02), women's formal education (AOR: 0.37, 95%CI: 0.19-0.70), partners alcohol consumption (AOR: 3.32, 95%CI: 1.89-5.84), partners Khat chewing (AOR: 7.22, 95%CI: 4.12-12.65) and poor social support (AOR: 2.47, 95%CI: 1.43-4.27) were significantly associated with current IPV against women.

CONCLUSIONS

Women's experience of IPV on contraceptive users was found to be unacceptably high in the study area. Women's being rural residents, having poor social support and partners who drank alcohol and Khat chewing were predictors of women's experience of IPV. Thus, interventions in improving women's educational status, strengthen the social support systems, and the behavior of partners who use stimulant substances are highly relevant to tackle IPV among contraceptive users in the primary healthcare setting.

Associated factors of diet quality among people living with HIV/AIDS in Ghana

INTRODUCTION

Nutrition is a very important element of a comprehensive care for people living with HIV/AIDS (PLHIV), especially in resource-constrained settings where malnutrition and food insecurity are common. Dietary diversity is a useful indication of nutritional adequacy (diet quality) in people of all ages. An optimally diverse diet strengthens the body's immune system.

OBJECTIVE

This study aimed to assess diet quality and its associated factors among PLHIV.

METHODS

A facility-based cross-sectional study design was employed to select 440 PLHIV from two hospitals in the Eastern Region of Ghana. Dietary intakes were determined using 24-hour recall. A stadiometer and bioimpedance analysis machine were used to obtain anthropometric and body composition data. Diet quality was assessed using FAO's individual dietary diversity score (IDDS) as a proxy. SPSS version 20 was used for analysis. Odds ratios and ordinal logistic regression were used to identify factors associated with diet quality among the PLHIV. P-value was set at 0.05.

RESULTS

Most of the PLHIV (73%) consumed from 'Starchy staple" food group. Less than 20% of the study sample consumed 'Fruits' and 'Vegetables' (17% and 14% respectively) a day before the survey. The mean IDDS was 4.11 (SD = 1.29). Overall, most of the PLHIV (56%) had medium IDDS which is equivalent to "diet needing improvement', 14% had higher IDDS (good diet), whiles about 31% of the participants actually had poor diet (lower IDDS). Associated factors of diet quality were age (AOR = 0.966: 95%CI: 0.936-0.997: p = 0.031), married (AOR = 4.634: 95%CI: 1.329-16.157: p = 0.0016), separated (AOR = 0.0203: 95%CI: .036-0.994: p = 0.049), and daily meal frequency (AOR = 0.441: 95%CI: .478-1.948: p = 0.020). Overall, the model accounts for about 20% of the variation in diet quality of the participants (pseudo-R square = 0.196).

CONCLUSION

This study demonstrates that most of the PLHIV did not consume good diet which may have an implication on their immune system, which is already under attack by HIV, and probably emerging infections. Age, marital status, and meal frequency were the variables that predicted diet quality among the study participants.

Magnitude of self-harm and associated factors among postnatal mothers attending immunization clinics at public health facilities in Boneya Boshe Woreda, Western Ethiopia, 2023: institution-based cross-sectional study design

BACKGROUND

Self-harm is a preventable, but a leading, cause of maternal morbidity and mortality all over the world, with a significant impact on healthcare systems.

OBJECTIVE

To assess the magnitude of self-harm and associated factors among postnatal mothers attending immunization clinics.

METHODS

An institution-based cross-sectional study was employed among postnatal mothers attending infant immunization clinics at public health facilities in Boneya Boshe Woreda, Western Ethiopia, 1 October to 30 October 2023. A pretested, face-to-face interviewer-administered structured questionnaire prepared by Kobo Toolbox was used to collect the data. Both bivariable and multivariable logistic regression analyses were done. The level of significance was declared at p-value <0.05 with a 95% CI.

RESULTS

Among the 423 mothers enrolled in the study, 415 of them finally participated, at a response rate of 98.10%. The magnitude of self-harm was 12.53% (95% CI: 9.33, 15.73). Involvement of husband in maternity and child healthcare (AOR = 1.90; 95% CI: 1.12, 2.10), depression (AOR = 2.79; 95% CI: 2.14, 6.94), loneliness (AOR = 2.49; 95% CI: 1.15, 5.40), postpartum intimate partner violence (AOR = 2.15; 95% CI: 1.01, 4.54), average monthly income (AOR = 3.70; 95% CI: 2.17, 10.50), and postnatal care (AOR = 2.72; 95% CI: 1.28, 5.80) were significantly associated factors.

CONCLUSION AND RECOMMENDATIONS

The study sought a magnitude of self-harm that was slightly higher than the previous study conducted in the northern part of Ethiopia. Therefore, healthcare providers should focus on identified factors during postnatal care to overcome them. Similarly, the concerned body should develop an effective strategy based on the identified factors to pay attention to postnatal mothers.

Extended postpartum intimate partner violence and its associated factors: community-based cross-sectional study design

BACKGROUND

Intimate partner violence is a global problem that threatens mothers. It has multidimensional consequences but has not gained attention from scholars after childbirth.

OBJECTIVE

To assess the prevalence of extended postpartum intimate partner violence and its associated factors.

METHOD

A community-based cross-sectional study design was employed among 570 postpartum mothers in Arba Minch Town, Southern Ethiopia, from May 21st to June 21st, 2022. A pretested, face-to-face interviewer-administered structured questionnaire was used. Bivariable and multivariable logistic regression analyses were used. The level of statistical significance was declared at P < 0.05 with a 95% CI.

RESULTS

Overall, the prevalence of extended postpartum intimate partner violence was 45% (95% CI: 40.89, 49.20). Participants whose husband has no formal education (AOR = 3.62; 95%CI: 1.32, 9.90) and only secondary education (AOR = 2.96; 95%CI: 1.56, 5.48), husband alcohol consumption (AOR = 1.73; 95%CI: 1.06, 2.80), husband dominance in decision-making (AOR = 1.94; 95%CI: 1.13, 3.33), husband disappointment in the gender of the baby (AOR = 2.13; 95%CI: 1.28, 3.56), previous history of intimate partner violence (AOR = 5.71; 95%CI: 3.59, 9.07), and low social support (AOR = 4.37; 95%CI: 2.53, 7.55) were significantly associated factors.

CONCLUSIONS AND RECOMMENDATIONS

The prevalence of extended postpartum intimate partner violence was found to be high. Thus, increasing awareness of husbands with no formal education and having lower academic achievement, incorporating maternal social support assessment into maternity and child health care; teaching on alcohol reduction behavior and gender roles; and screening of mothers during the prenatal period should be given.

Systematic Review of the Psychometric Properties of Culturally Responsive Domestic Violence Measures

Domestic violence (DV) is a pervasive public health issue due to its high prevalence and the adverse effects it can have on individuals. Standardized measures can fail to account for within-group differences that are salient among diverse populations. The current review aims to systematically review and organize the psychometric studies of culturally responsive DV measures. The goal of the review is to inform researchers and practitioners about the validity and reliability of the existing measures to facilitate measure selection. Studies were included if they were validation studies of a DV measure, published in English in a peer-reviewed journal, demonstrated cultural responsivity, and provided evidence of validity or reliability. A total of seven studies were identified. Findings from this review showed that most participants were from South Asia or were South Asian immigrants. Some culturally specific tactics included being treated like a servant, eating last, being burned, and in-laws abuse. Most measures included in this review demonstrated compelling evidence of validity and reliability. More research is needed to develop and validate culturally responsive measures with distinctly diverse populations. Valid and reliable culturally responsive measures can be helpful for DV and non-DV service providers to precisely assess DV and provide appropriate services while documenting accurate DV prevalence rates.

Gender-Based Violence and Associated Factors Among Women with Disabilities in Jimma Town, Ethiopia

Background

Globally, women with disabilities have two times higher chance of suffering from violence compared to their non-disabled peers due to double discrimination. However, there is little evidence that quantifies the situation in this segment of the population by considering disability-related factors which make this group more vulnerable to gender-based violence in Ethiopia.

Objective

To assess the prevalence of gender-based violence and its associated factors among women with disabilities in Jimma town, southwest Ethiopia, 2020.

Methods

A community based cross-sectional study was conducted among a total of 308 women with disabilities. Bivariate and multivariable logistic regression analyses were carried out to identify factors associated with gender-based violence. The significance of the association was decided by using the 95% confidence interval of AOR at a p-value of <0.05 in the multivariable analysis.

Results

The lifetime prevalence of gender-based violence among women with disabilities was found to be 73.1, while 46.1% had experienced it during the last 12 months. Gender-based violence in the past 12 months was significantly associated with non-schooling (AOR=5.10; 95% CI, 1.51, 17.14), being in age group of 20–34 (AOR=3.5; 95% CI, 1.74, 7.30), having visual impairment (AOR=3.1; 95% CI, 1.27, 7.54), having hearing impairment (AOR=3.0; 95% CI, 1.36, 6.89), alcohol use behavior (AOR=4.1; 95% CI, 1.74, 9.55), and perceived stigma and discrimination (AOR=4.2; 95% CI, 2.44, 7.39).

Conclusion

Prevalence of gender-based violence among women with disabilities was found to be high in the study area. Educational status, age, type of disability, alcohol use behavior, and perceived stigma and discrimination were independent predictors of gender-based violence. Measures have to be taken to curb the problem by taking integrated interventions like enrolling girls in school and targeted health education towards identified factors by considering the heterogeneity of disabilities.

Prevalence and Associated Factors of Intimate Partner Violence Among Married Women During COVID-19 Pandemic Restrictions: A Community-Based Study

Ethiopia has taken unprecedented preventive measures, such as confinement to home and closure of schools and offices to halt the spread of Corona virus pandemic in the country. Unfortunately, such orders may have been associated with intimate partner violence (IPV) against women but there is no study conducted to assess the magnitude of IPV during the lock-downs in the country. Thus, this study intended to investigate the prevalence and associated factors of IPV against women during the COVID-19 pandemic restrictions. A community-based cross-sectional study was conducted on sample of 617 married or cohabited women. A systematic random sampling technique was employed to identify and enroll women who are married. A logistic regression analysis was used to identify the predictors of IPV among women and all statistical analyses were carried out using STATA 14.2. In this study, amongst the 589 married women who were included in the analysis, 22.4% [95% CI: 19.1%, 25.9%] were experienced at least one form of IPV. Additionally, 11.0%, 20.0%, and 13.8% of women also experienced physical, psychological, and sexual IPVs respectively. After adjusting for covariate; being illiterate [AOR=2.37: 95% CI 1.29, 4.35], having illiterate husband [AOR=2.67: 95% CI 1.36, 5.21], having substance user husband (alcohol, chat or cigarettes) [AOR=2.75: 95% CI 1.42, 5.34], and community tolerant attitude to violence [AOR=2.97: 95% CI 1.17, 7.61] were the independent predictors of IPV amongst married women. In conclusion, the prevalence of IPV among married women was comparable to the national pre-COVID figure of IPV. Therefore, national and regional governments should work toward enhancing gender equality, coupled with addressing risk factors at multiple levels, using community- and institution-based approaches to prevent IPV and to specifically achieve SDG5 of eliminating violence against women by 2030.

Risk Assessment Instruments for Intimate Partner Femicide: A Systematic Review

Intimate partner violence is a severe problem that has taken the lives of thousands of women worldwide, and it is bound to continue in the future. Numerous risk assessment instruments have been developed to identify and intervene in high-risk cases. However, a synthesis of specific instruments for severe violence against women by male partners has not been identified. This type of violence has specific characteristics compared to other forms of intimate partner violence, requiring individualized attention. A systematic review of the literature has been conducted to summarize the intimate partner homicide risk assessment instruments applied to this population. It has been carried out with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. The search strategy yielded a total of 1,156 studies, and only 33 studies met eligibility criteria and were included in the review. The data of these studies were extracted, analyzed, and presented on study characteristics (country and year, sample, data sources, purpose of the studies) and main findings (a brief description of the instruments, risk factor items, psychometric properties). The results indicate that the Danger Assessment, the Danger Assessment for Immigrants, the Danger Assessment for Law Enforcement, the Danger Assessment-5, the Taiwan Intimate Partner Violence Danger Assessment, the Severe Intimate Partner Risk Prediction Scale, The Lethality Screen, and the H-Scale are specific risk assessment instruments for predicting homicide and attempted homicide. There are differences in the number and content of risk assessment items, but most of them include the evidence's critical factors associated with homicide. Validity and reliability scores of these instruments vary, being consistency and accuracy medium-high for estimating homicide. Finally, implications for prediction and prevention are noted, and future research directions are discussed.

The evaluation of the subjection of married women to domestic violence in terms of submissive behaviors in Turkey: A descriptive study

PURPOSE

This study aimed to evaluate the subjection of married women living in the center of a city in Turkey to domestic violence in terms of submissive behaviors.

DESIGN AND METHODS

The study was descriptive and cross-sectional. The data were collected from married women (n = 7097) who volunteered to participate in the study and completed a survey form between September 2019 and February 2020.

RESULTS

Submissive behavior scores were high in the women subjected to physical violence, based on many characteristics, and the difference between groups was statistically significant (p < 0.05).

PRACTICAL IMPLICATIONS

Nurses should be active participants in the diagnosis, treatment, care, and rehabilitation processes of women who have suffered from violence and should support them in improving their coping skills.

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.

Factors associated with violence against women in a representative sample of the Lebanese population: results of a cross-sectional study

To evaluate the prevalence of violence against women (VAW) and assess factors associated with VAW among a representative sample of the Lebanese population. This cross-sectional study was carried out between September and December 2018. Participants from all Lebanese governorates were enrolled in this study using a proportionate random sample. The percentages of women who were exposed to physical and non-physical abuse were 37.1% and 49.4% respectively. Factors associated with physical abuse were being divorced, having a partner addicted to substances and alcohol, or with a history of threats, violence, assaults, and crimes, higher stressful life experiences, and abuse reported from childhood (physical, sexual, or psychological). Non-physical abuse was associated with abuse reported from childhood (physical, sexual, or psychological), higher stressful life experiences, and the fact that the partner is addicted to substances and alcohol, or has a history of threats. Our results suggest that being divorced, illiterate, and unemployed, having an addicted partner, and having experienced child abuse are all factors that are associated with more violence against women.

Elaboração e validação de uma tecnologia educacional acerca da violência contra a mulher

RESUMO Objetivo elaborar e validar uma tecnologia educacional acerca da violência contra a mulher. Método estudo metodológico de validação de conteúdo e aparência. Para a validação, participaram deste estudo 11 especialistas de conteúdo e técnicos, 7 especialistas de design e 79 mulheres. Foram utilizados três instrumentos para a coleta de dados, um para cada grupo de participantes, e os dados foram analisados quanto ao nível de concordância e Índice de Validade de Conteúdo. Resultados a média de concordância dos especialistas de conteúdo e técnicos foi de 87%, o Índice de Validade de Conteúdo global por parte dos especialistas de design foi de 0,92 e o nível de concordância das respostas positivas pelo público-alvo foi de 96,2%. Conclusão e implicações para a prática o Alertômetro mostrou-se uma tecnologia educacional válida para ser utilizada, pois promove conhecimento acerca das diversas manifestações da violência contra a mulher.