Date Published: May 1, 2019
Publisher: Public Library of Science
Author(s): Bikila Lencha, Gemechu Ameya, Girma Baresa, Zanebe Minda, Gemechu Ganfure, Sharon Mary Brownie.
Intimate partner violence (IPV) against women is a major public health concern in low income countries. Violence against pregnant women has adverse effects on maternal and newborn outcomes. This study aimed to assess the prevalence and associated factors of intimate partner violence in Southeast Ethiopia pregnant women.
Institutional based cross-sectional study was conducted on pregnant women who were attending antenatal care (ANC) in Bale Zone health institution during study period. Face to face interviews were conducted using a pre-tested structured questionnaire. Data related to socio-demographic characteristic, pregnancy and reproductive history, intimate partner behavior and IPV encountered during recent pregnancy was gathered for this study. Descriptive analysis and logistic regression were used for the data analysis. Odds ratio with 95% CI was computed to determine the presence and strength of associated factors with IPV.
A total of 612 pregnant women participated in the study. Of these, 361 (59.0%) pregnant women faced at least one type of IPV during the recent pregnancy. Physical violence (20.3%), sexual violence (36.3%), psychological/emotional violence (33.0), controlling behavior violence (30.4%) and economic violence (27.0) were the type of IPV encountered by participants. An intimate partners who were drank alcohol [AOR = 2.9; 95% CI: (1.5–5.4)], partners who were chewed Khat [AOR = 1.7; 95% CI: (1.1–2.6)], partners who were smoked cigarette [AOR = 2.6; 95% CI: (1.4–4.9)], partners who had aggressive behavior [AOR = 2.8; 95% CI: (1.7–4.6)], having partner age ≥30 year old [AOR = 1.8; 95% CI: (1.2–2.9)], unwanted pregnancy [AOR = 3.3; 95% CI: (1.9–5.5)] and history of adverse pregnancy outcome [AOR = 2.1; 95% CI: (1.2–3.6)] that were the factors that significantly associated with IPV of the pregnant women.
The prevalence of IPV during pregnancy was high among the study participants. Intimate partners’ use of substance, intimate partners’ aggressive behavior, older intimate partners, unwanted pregnancy and history of adverse birth outcome were identified as associated factors for IPV. IPV needs to be considered during ANC service and integrated into the sexual and reproductive health education. Community-based interventions should be advocated as a way of health promotion. Counseling, awareness creation, service provision and program design on IPV is mandatory to minimize the victim.
Intimate partner violence (IPV) refers to any behavior within an intimate relationship that causes physical, psychological, sexual, controlling and economic violence against a partner in the relationship . Intimate partner is the husband/companion with whom the woman is having sexual relationships or the father of the child that she is carrying in her womb. IPV affects pregnant women’s health and sometimes results in maternal mortality and adverse newborn out come. Maternal distress, inadequate prenatal care, preterm birth, low birth weight, miscarriage, induced abortion, spontaneous abortion, intra uterine growth restriction, pre-eclampsia, third trimester bleeding, premature rupture of membranes, sexually transmitted infections and maternal death are associated with intimate partner violence during pregnancy [2–5]. This effect is often not recognized by policy-makers and local stakeholders working on women’s health [6–8].
The severity and the type of the intimate partner violence in pregnancy may determine the severity of the outcome [17, 18]. In the current study 59% [95% CI: (55.0–62.8)] of pregnant women encountered at list one type of IPV. This finding supports prior work in IPV prevalence which reflected 61.8% in Gambia and 55% in South Africa [1, 19]. This finding is higher than studies conducted in other region of Ethiopia [20, 21]. The observed difference may be due to variation in the type of violence included in the study. Most of the studies only focused on physical violence while in our case the five type of the intimate partner violence were include. In our study, about 6.7% of the pregnant women faced all the five types of violence while more than one in ten women encountered the three common type of violence (physical, sexual and psychological). Although such high prevalence of IPV was observed in the low income country, required attention is not yet given for violence during the pregnancy .
The prevalence of intimate partner violence in the Bale zone is high as compared to other areas. Six in ten women experienced at least one act of IPV during pregnancy. Sexual and psychological violence were the most frequent type of IPV. Alcohol drinking habit, Khat chewing, cigarette smoking, fighting with other men and older age were pregnant women’s intimate partner related factors that were independently associated with the IPV. Pregnancy and reproductive history such as miscarriage, abortion and/or still birth and unwanted pregnancy were also significantly associated with IPV against pregnant women. IPV prevention should be incorporated in high school curriculum as well as sexual and reproductive health education programs. Creating the community awareness to change beliefs that are culturally embedded in collaboration with the indigenous leadership, community leader, and other key stakeholders is mandatory. Policy makers need to consider screening for IPV in the antenatal care service as a component. It is also better to include IPV as one component of community health extension package. Those identified behavioral factors call for policy interventions. Further studies that show the effect of intimate partner violence on the pregnancy outcome need to be conducted.