Intimate Partner Violence against Women in West Ethiopia: Magnitude, Associated Factors, Health Effects, and Community Perceptions.
| dc.contributor.advisor | Fantahun, Mesganaw(MD, MPH, PhD) | |
| dc.contributor.advisor | Dr.Worku, Alemayehu(BSc, MSc, PhD) | |
| dc.contributor.author | Garoma, Sileshi (Phd) | |
| dc.date.accessioned | 2022-04-28T06:28:58Z | |
| dc.date.accessioned | 2023-11-05T15:12:35Z | |
| dc.date.available | 2022-04-28T06:28:58Z | |
| dc.date.available | 2023-11-05T15:12:35Z | |
| dc.date.issued | 2012-10 | |
| dc.description.abstract | Background Intimate partner violence against women is a psychological, physical, and sexual abuse directed towards spouses. Globally it is the most pervasive yet underestimated human rights violation. Intimate partner violence against women is known to undermine the physical, mental and reproductive well-being of women and children. Since much of this is hidden inside the home, it is difficult to document it and work towards its prevention. Empirical data are needed to take appropriate measures in curbing the problem. Objective The overall aim is to assess the magnitude, associated factors and adverse health effects of intimate partner violence against women, and explore the community’s perception towards such violence in East Wollega Zone, West Ethiopia. Methods Community-based cross-sectional and case-control studies were conducted from January to June, 2011 using standard World Health Organization multi-country study questionnaire. To assess the magnitude, associated factors, and adverse health effects of intimate partner violence against women, a sample of 1540 ever married/cohabiting women aged 15-49 years was randomly selected from urban and rural settings of the study area. To examine the association between intimate partner violence against women and under-five deaths, a sample of 858 biological mothers aged 15-49 years (286 cases and 572 controls) was included. Cases were biological mothers of the under-five deceased within two years preceding the survey, whereas controls were biological mothers of live under-five matched by age and sex of the child as well as area of residence. Data were double-entered into Epi DATA and analyzed using SPSS version 19 and STATA 11 and principally analyzed using logistic regression models. Online databases were searched from the earliest entry to December 2010 for systematic review and meta-analysis to assess the effect of intimate partner violence against women on under-five mortality. On the final search, 11 studies from developing countries were inputted into Metaesy add-in for MS Excel version 1.0.4 software for meta-analysis. Random effect model using DerSimonian and Laird's (DL) estimator was used to calculate the pooled estimates of the studies. In addition, a total of 12 focus group discussions involving 55 men and 60 women were conducted from December, 2011 to January, 2012 to explore the perceptions of the community towards intimate partner violence against women. Discussants were purposively selected from the study area. The analyses followed the procedure for qualitative thematic content analysis. Results Lifetime and current (last 12 months) prevalence of intimate partner violence against women showed 76.5%; 95% CI, 74.4 to 78.6% and 72.5%; 95% CI, 70.3 to 74.7%, respectively. The joint occurrences of psychological, physical, and sexual violence were 56.9%. The patterns of the three forms of violence are similar across the time periods. Rural residents (AOR, 0.58; 95% CI, 0.34 to 0.98), literates (AOR, 0.65; 95% CI, 0.48 to 0.88), and women autonomy (AOR, 0.46; 95% CI, 0.27 to 0.76) were at decreased likelihood to have lifetime intimate partner violence against women. Yet, older women were nearly four times (AOR, 3.36; 95% CI, 1.27 to 8.89) more likely to report the incident. On the other hand, marriage by abduction (AOR, 3.71; 95% CI, 1.01 to 13.63), male polygamy (AOR, 3.79; 95% CI, 1.64 to 8.73), spousal alcoholic consumption (AOR, 1.98; 95% CI, 1.21 to 3.22), spousal hostility (AOR, 3.96; 95% CI, 2.52 to 6.20), and previous witnesses of parental violence (AOR, 2.00; 95% CI, 1.54 to 2.56) were factors associated with an increased likelihood of intimate partner violence against women. Nearly two-thirds (64.1%) of physically abused women had injuries to their body parts. The vast majority (93.3%) experienced symptom of mental distress. Sixty four percent of the abused women compared to 41.7% of the non-abused ever had symptom of sexually transmitted infections. Furthermore, 16% and 7.2% of the abused women had unintended pregnancy and termination of pregnancy, respectively while only 11.3% and 4.8% of the non-abused had the same respectively. On the other hand, 82.2% of the cases and 68.6% of the controls ever experienced at least an incident of intimate partner violence against them while 61.9% and 50.9% of the respective groups had ever experienced all forms of intimate partner violence. Intimate partner violence against women is independently associated with symptoms of mental distress, sexually transmitted infections, unintended pregnancy and termination of pregnancy. Mothers who have ever experienced controlling behavior in marriage were more than four times (AOR, 4.27; 95% CI, 0.97 to 18.89) as likely as mothers who did not to have under-five mortality. In addition, mothers who experienced two forms of violence at the same time were more than two times (AOR, 2.24; 95% CI, 1.31 to 3.85) as likely as mothers who did not to have under-five mortality. Ever experiences of the three forms of maternal intimate partner violence were more than two and half times (AOR, 2.55; 95% CI, 1.66 to 3.92) as likely to have the same. Similar effect was observed in meta-analysis, with the mean effect size, 0.23; 95% CI, 0.16 to 0.32 is significantly different from zero and the value of pooled Odds Ratio, 1.34; 95% CI, 1.12 to1.46). In focus group discussions, most of the discussants confirmed that the community has divergent views on the acceptance of intimate partner violence against women. The act is acceptable in circumstances of practicing extra marital sexual affairs and suspected sexual infidelity. Most discussants perceived that the majority of women in their area tolerate the incident due to traditional beliefs, norms and attitudes of the community and very few, including victims, defend themselves against violent husbands/partners. Biased arbitration is marked by excluding women from reconciliatory local elders. The suggested measures by the community to stop or reduce violence against women targeted provision of education for individuals, family, community, and society. Conclusion In their lifetime, three out of four women experienced at least an incident of intimate partner violence against them. In the study area, various socio-demographic and behavioral factors are associated with intimate partner violence against women. Moreover, intimate partner violence against women negatively affects the physical, mental and sexual/reproductive health of women. Further, it is independently associated with under-five mortality. Measures suggested by the community to stop or prevent the act were focused on provision of education about women’s right to individuals, family, community, and society. Recommendations There are needs for an urgent attention at all levels including policymakers, stakeholders and professionals to alleviate the situation. Involving men in maternal and child health programs could be one strategy to address the issue of intimate partner violence against women. Moreover, efforts to dispel myths, misconceptions and beliefs of the community should be strengthened. Finally, extensive national studies are encouraged to address the issues of intimate partner violence against women and under-five mortality. | en_US |
| dc.identifier.uri | http://etd.aau.edu.et/handle/123456789/31537 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Ababa University | en_US |
| dc.subject | Intimate partner violence, Women, Risk factors, Health effects, Community perception, West Ethiopia | en_US |
| dc.title | Intimate Partner Violence against Women in West Ethiopia: Magnitude, Associated Factors, Health Effects, and Community Perceptions. | en_US |
| dc.type | Thesis | en_US |