Adult Health Nursing

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Browsing Adult Health Nursing by Author "Abebe Gobezayehu"

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    Violence Against Women;Intimate Partner Violence:Association with Maternal Health Service Utilization and Women Empowermant
    (Addis Ababa Universtity, 2025) Bazie Mekonnen; Negussie Deyessa; Cranner John; Abebe Gobezayehu
    Background: Maternal and child mortality from preventable causes remains unacceptably high globally. The majority of the deaths occur in Sub-Saharan Africa (SSA) countries. Adequate and timely utilization of maternal and child health services(MCH) could avert many of these deaths. However, utilization of MCH services remains low in the SSA region. Different factors may deter women from access to and receipt of maternal health services. Intimate partner violence (IPV) is one such common factor. IPV affects maternal health service utilization by denying women’s autonomy in decision making, women rights to freedom of movement, and making the victim economically dependent. It is the most prevalent form of violence against women and a common global human rights violation. Objective: The aim of this study was to assess the association of intimate partner violence on maternal health service utilization and women empowerment, otherwise known as women autonomy. Method: The data source for this study was the 2016 Ethiopia Demographic and Health survey (EDHS) dataset, which is de-identified, de-linked and publicly available. The EDHS collected data using stratified multistage proportional-to-size allocation sampling technique. We used complex samples regression analysis for this study. In addition, we employed Principal Component Analysis (PCA) and k-means clustering for our research on the association between IPV and women empowerment. This study examined for the presence of a dose-response relationship between IPV sub-types (emotional, sexual, and physical IPV) and maternal antenatal service utilization in paper I. The second paper addressed the research question on whether women empowerment protects mothers from experiencing intimate partner violence. Our third paper assessed the relationship between women empowerment and maternal healthcare utilization for under-five illnesses. Results: About 2,599 (weighted) mothers currently married or living with a partner were included in our assessment of the relationship between IPV and ANC utilization. Only 30.2% of respondents had utilized adequate ANC service for the last child (ANC-4). The prevalence of maternal life time experience of IPV ranged from 10.3% for sexual violence, to 23.0% and 22.9% for emotional and physical violence, respectively. The result from the full model complex samples logistic regression analysis found a dose-response relationship between IPV sub-scale scores and maternal antenatal service utilization. A unit increase in maternal life time experience of emotional IPV score from 0 through 3 decreased the likelihood of maternal ANC-4 utilization by 22.0% (aOR=0.78, CI=0.64, 0.97). A unit increase in the sexual IPV score from 0 to 3 decreased ANC-4 by 32.0% (aOR=0.68, CI=0.50, 0.92). On the other hand, a unit increase in the physical IPV score from 0 to 7 increased ANC uptake slightly, although the change was not significant (aOR=1.15, CI=0.97, 1.35 ). Our research on the relationship between women empowerment and IPV involved 3689 (weighted) women currently married or living with a partner. The majority (64.3%) of the respondents constituted the more empowered cluster, while 16.0% were from the most empowered cluster. Women empowerment was found to have a significant protective effect on emotional IPV. Women in the most empowered cluster were 69% less likely to experience emotional IPV compared to the least empowered cluster counterparts (aOR= 0.31, CI= 0.17, 0.53). However, we found no significant association between women empowerment and, sexual or physical partner violence. Our assessment of the relationship between women empowerment and healthcare utilization for under-five illnesses included 2101 cases of children. Children whose mothers are empowered with attitude towards wife beating were found to have 59% more probability of receiving healthcare services towards all U5 illnesses in the complex samples ordinal regression (β= 0.46, cu-OR= 1.59, P < 0.01). Children of mothers with no healthcare access problem were also more likely to get health services for all U5 illnesses (β= 0.42, cu-OR= 1.52, P= 0.01). Conclusion: Intimate partner violence deters maternal health service utilization. Women empowerment, however, has a positive effect on healthcare seeking. In addition, empowerment protects women from experiencing intimate partner violence.