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      Prevalence of domestic violence and associated factors among pregnant women attending antenatal care service at University of Gondar Referral Hospital, Northwest Ethiopia

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          Abstract

          Background

          Domestic violence during pregnancy with its many negative fetal and maternal outcomes is a common public health problem all over the world. Nonetheless, the problem is not well investigated and understood in Ethiopia. Hence, this study aimed to assess the prevalence of domestic violence and associated factors among pregnant women attending the University of Gondar Referral Hospital antenatal care (ANC) services.

          Methods

          A hospital-based cross-sectional study was conducted from March–May 2016. A total of 450 pregnant women who visited the clinic were included in the study. A systematic random sampling technique was used to select study participants, and a pretested structured questionnaire was employed to collect data. The WHO multi-country study on women’s health and domestic violence against women was used to assess the violence against pregnant women. Descriptive statistics such as means, frequencies and percentages were computed. A multivariable logistic regression analysis was carried out to identify factors associated with domestic violence, and variables with p-values < 0.05 were considered as statistically significant.

          Results

          Of the total pregnant women surveyed, 58.7% were victims of at least one form of domestic violence during pregnancy, emotional violence being the most common (57.8%). The multivariable logistic regression analysis showed that house wives (adjusted odd ratio (AOR) = 3.43, 95% CI: 1.63, 7.21), women with no salary of their own (AOR = 3.37, 95% CI: 2.14, 7.95), partners’ daily use of alcohol (AOR = 4.59, 95%CI: 1.82, 11.56), women who believed in women’s rights to decide to be pregnant (AOR = 1.77, 95%CI: 1.18, 2.89), and women who disobeyed their partner (AOR = 2.36, 95%CI: 1.37, 4.07) were found to be positively and significantly associated with domestic violence during pregnancy.

          Conclusion

          A high proportion of pregnant women experienced domestic violence during their pregnancy. Being a housewife, poor income status, partners’ use of alcohol, unwanted pregnancy, and disobeying of the women to their partner were factors associated with domestic violence during pregnancy. Evidence based female empowerment, especially the empowerment of women without income of their own, partner education and positive relations between partners are very important to minimize the problem.

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          Most cited references30

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          Physical and mental health effects of intimate partner violence for men and women

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            Physical health consequences of physical and psychological intimate partner violence.

            A L Coker (2000)
            Past studies that have addressed the health effects of intimate partner violence (IPV) have defined IPV as violence based on physical blows that frequently cause injuries. To our knowledge, no epidemiologic research has assessed the physical health consequences of psychological forms of IPV. To estimate IPV prevalence by type and associated physical health consequences among women seeking primary health care. Cross-sectional survey. A total of 1152 women, aged 18 to 65 years, recruited from family practice clinics from February 1997 through January 1999 and screened for IPV during a brief in-clinic interview; health history and current status were assessed in a follow-up interview. Of 1152 women surveyed, 53.6% ever experienced any type of partner violence; 13.6% experienced psychological IPV without physical IPV. Women experiencing psychological IPV were significantly more likely to report poor physical and mental health (adjusted relative risk [RR], 1.69 for physical health and 1.74 for mental health). Psychological IPV was associated with a number of adverse health outcomes, including a disability preventing work (adjusted RR, 1.49), arthritis (adjusted RR, 1.67), chronic pain (adjusted RR, 1.91), migraine (adjusted RR, 1.54) and other frequent headaches (adjusted RR, 1.41), stammering (adjusted RR, 2.31), sexually transmitted infections (adjusted RR, 1.82), chronic pelvic pain (adjusted RR, 1.62), stomach ulcers (adjusted RR, 1.72), spastic colon (adjusted RR, 3.62), and frequent indigestion, diarrhea, or constipation (adjusted RR, 1.30). Psychological IPV was as strongly associated with the majority of adverse health outcomes as was physical IPV. Psychological IPV has significant physical health consequences. To reduce the range of health consequences associated with IPV, clinicians should screen for psychological forms of IPV as well as physical and sexual IPV.
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              A Systematic Review of African Studies on Intimate Partner Violence against Pregnant Women: Prevalence and Risk Factors

              Background Intimate partner violence (IPV) is very high in Africa. However, information obtained from the increasing number of African studies on IPV among pregnant women has not been scientifically analyzed. This paper presents a systematic review summing up the evidence from African studies on IPV prevalence and risk factors among pregnant women. Methods A key-word defined search of various electronic databases, specific journals and reference lists on IPV prevalence and risk factors during pregnancy resulted in 19 peer-reviewed journal articles which matched our inclusion criteria. Quantitative articles about pregnant women from Africa published in English between 2000 and 2010 were reviewed. At least two reviewers assessed each paper for quality and content. We conducted meta-analysis of prevalence data and reported odds ratios of risk factors. Results The prevalence of IPV during pregnancy ranges from 2% to 57% (n = 13 studies) with meta-analysis yielding an overall prevalence of 15.23% (95% CI: 14.38 to 16.08%). After adjustment for known confounders, five studies retained significant associations between HIV and IPV during pregnancy (OR1.48–3.10). Five studies demonstrated strong evidence that a history of violence is significantly associated with IPV in pregnancy and alcohol abuse by a partner also increases a woman's chances of being abused during pregnancy (OR 2.89–11.60). Other risk factors include risky sexual behaviours, low socioeconomic status and young age. Conclusion The prevalence of IPV among pregnant women in Africa is one of the highest reported globally. The major risk factors included HIV infection, history of violence and alcohol and drug use. This evidence points to the importance of further research to both better understand IPV during pregnancy and feed into interventions in reproductive health services to prevent and minimize the impact of such violence.
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                Author and article information

                Contributors
                elfafekadu@gmail.com
                gyigezaw@gmail.com
                kassalemu@gmail.com
                t_awoke@yahoo.com
                tammiruminwuyie@yahoo.com
                tinsaegenet1990@gmail.com
                destaw.fetene@gmail.com
                Journal
                BMC Womens Health
                BMC Womens Health
                BMC Women's Health
                BioMed Central (London )
                1472-6874
                14 August 2018
                14 August 2018
                2018
                : 18
                : 138
                Affiliations
                [1 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Gynecology and Obstetrics, , School of Medicine, College of Medicine and Health Sciences, University of Gondar, ; Gondar, Ethiopia
                [2 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Epidemiology and Biostatistics, , Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, ; Gondar, Ethiopia
                [3 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Dabat Research Centre Health and Demographic Surveillance System, , Institute of Public Health College of Medicine and Health Science, University of Gondar, ; Gondar, Ethiopia
                Author information
                http://orcid.org/0000-0001-7129-8551
                Article
                632
                10.1186/s12905-018-0632-y
                6092801
                30107793
                7e7a0149-4288-47bd-b835-4928ec34850a
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 13 February 2018
                : 3 August 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Obstetrics & Gynecology
                domestic violence,emotional violence,physical violence,sexual violence
                Obstetrics & Gynecology
                domestic violence, emotional violence, physical violence, sexual violence

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