Social ecological factors and intimate partner violence in pregnancy

PLOS ONE, Nov 2019

Background Intimate partner violence (IPV) during pregnancy increases adverse pregnancy outcomes. Knowledge of societal, community, family and individual related factors associated with IPV in pregnancy is limited in Ethiopia. Our study examined these factors in an Ethiopian context. Materials and methods A cross sectional study was conducted among pregnant women attending antenatal care at governmental health institutions, using a consecutive probability sampling strategy. A total of 720 pregnant women were interviewed by five trained nurses or midwives, using a standardized and /pretested survey questionnaire. Bivariate and multivariate logistic regression analyses were applied to assess factors contributing to IPV. We used Akaike’s information criteria, to identify the model that best describes the factors influencing IPV in pregnancy. Results Among the women interviewed, physical IPV was reported by 35.6%, and lifetime emotional or physical abuse by 81.0%. Perceiving violence as a means to settle interpersonal conflicts, presence of supportive attitudes of wife beating in the society, regarding violence as an expression of masculinity, and presence of strict gender role differences in the society, were all positively associated to IPV in pregnancy. The presence of groups legitimizing men’s violence in the community, feeling isolated, having no social support for victims, and presence of high unemployment, were the perceived community related factors positively associated with IPV in pregnancy. Conclusion IPV in pregnancy is very prevalent in Ethiopia and is associated with multiple social ecologic factors. Reduction of IPV in pregnancy calls for cross sectorial efforts from stakeholders at different levels.

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Social ecological factors and intimate partner violence in pregnancy

March Social ecological factors and intimate partner violence in pregnancy Editor: Laura A. Magee King's College London UNITED KINGDOM Bosena Tebeje Gashaw 0 Berit Schei Jeanette H. Magnus 0 College of Health Sciences, Jimma University , Jimma , Ethiopia , 2 Faculty of Medicine, University of Oslo , Oslo , Norway , 3 Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, University of Science and Technology , Trondheim , Norway , 4 Department of Obstetrics and Gynaecology, St. Olav's hospital, Trondheim University Hospital , Trondheim , Norway , 5 Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine , New Orleans, Louisiana , United States of America Intimate partner violence (IPV) during pregnancy increases adverse pregnancy outcomes. Knowledge of societal, community, family and individual related factors associated with IPV in pregnancy is limited in Ethiopia. Our study examined these factors in an Ethiopian context. - Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: This publication was supported by NORAD (Norwegian Agency for Development Cooperation) under the NORHED-Program, Agreement no.ªETH-13/0024". The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Materials and methods A cross sectional study was conducted among pregnant women attending antenatal care at governmental health institutions, using a consecutive probability sampling strategy. A total of 720 pregnant women were interviewed by five trained nurses or midwives, using a standardized and /pretested survey questionnaire. Bivariate and multivariate logistic regression analyses were applied to assess factors contributing to IPV. We used Akaike's information criteria, to identify the model that best describes the factors influencing IPV in pregnancy. Results Among the women interviewed, physical IPV was reported by 35.6%, and lifetime emotional or physical abuse by 81.0%. Perceiving violence as a means to settle interpersonal conflicts, presence of supportive attitudes of wife beating in the society, regarding violence as an expression of masculinity, and presence of strict gender role differences in the society, were all positively associated to IPV in pregnancy. The presence of groups legitimizing men's violence in the community, feeling isolated, having no social support for victims, and presence of high unemployment, were the perceived community related factors positively associated with IPV in pregnancy. Conclusion IPV in pregnancy is very prevalent in Ethiopia and is associated with multiple social ecologic factors. Reduction of IPV in pregnancy calls for cross sectorial efforts from stakeholders at different levels. Background Intimate partner violence (IPV), is an important global public health and human rights issue, with significant health and socioeconomic development consequences [1]. Violence against women may occur at any stage of a woman's life, including during pregnancy. The overall global estimates of IPV around the time of pregnancy vary between 3±30% [2], with higher prevalence reported in developing countries [3]. In Africa, the prevalence of pregnancy related IPV is reported to be between 23±40% [4]. Prior studies in Ethiopia indicate a very high life time prevalence of IPV among reproductive age women at 50±78% [5±10], and pregnancy related IPV between 11±29% [11±15]. The majority of these studies examined factors contributing to IPV in pregnancy related to the individual context, such as childhood inter-parental exposure, early marriage, dowry payment, residence, alcohol use and or education. It is important to conceptualize violence as a multifaceted phenomenon grounded in the interplay across societal, community, family, and individual levels. There is a lack of studies that simultaneously examine societal, community, family, and individual related factors contributing to IPV in pregnancy in Africa and in Ethiopia in particular. A healthy pregnancy is required for favourable maternal and child health outcomes. Preg nancies affected by IPV are reported to have an increased incidence of low maternal weight gain, anaemia, infection, first/second trimester bleeding, late entry into antenatal care (ANC), preterm labour, premature birth and low birth weight baby [16, 17]. Homicide is also one of the leading causes of pregnancy associated death, commonly as a consequence of IPV [18]. IPV may commence or escalate in pregnancy [19]. Studies report that IPV during pregnancy is more common than some maternal health conditions routinely screened for during antenatal care [4, 20]. The causes for IPV are complex and dependent on the context [21]. Many of the previous studies have identified various individ (...truncated)


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Bosena Tebeje Gashaw, Berit Schei, Jeanette H. Magnus. Social ecological factors and intimate partner violence in pregnancy, PLOS ONE, 2018, Volume 13, Issue 3, DOI: 10.1371/journal.pone.0194681