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Associations of reproductive coercion and intimate partner violence with overt and covert family planning use among married adolescent girls in Niger.

ABSTRACT: Background:In Niger the prevalence of girl child marriage and low female control over family planning (FP) has resulted in the world's highest adolescent fertility. Male control of FP is associated with intimate partner violence (IPV) and reproductive coercion (RC). We assessed associations of IPV and RC with FP use among married adolescent girls (ages 13-19 years) in Dosso, Niger (N?=?1072). Methods:Multivariable, cross-sectional regression models assessed associations between physical IPV, sexual IPV, and RC and any FP use, FP use with husband knowledge (overt use), and FP use without husband knowledge (covert use). Findings:One in four married adolescent girls using FP reported doing so without husband's knowledge. Unadjusted and adjusted models indicated that physical IPV and RC were associated with covert FP use (vs. no use and vs. overt use), but not with overt use vs. no use. Only physical IPV remained significantly associated with covert use in models including all three forms of violence (AOR: 1.94 vs. any use; AOR: 3.63 vs. overt use). Interpretation:Married adolescents experiencing physical IPV or RC were more likely that others to use FP without their husbands' knowledge. No form of GBV affected odds of FP use with husbands' knowledge. Current results suggest caution regarding promoting engagement of men in decisions to use FP in this context, as this may undermine the reproductive autonomy of girls and women who will choose to use FP without the knowledge of their male partners.

SUBMITTER: Silverman JG

PROVIDER: S-EPMC7198910 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Associations of reproductive coercion and intimate partner violence with overt and covert family planning use among married adolescent girls in Niger.

Silverman Jay G JG Challa Sneha S Boyce Sabrina C SC Averbach Sarah S Raj Anita A

EClinicalMedicine 20200503

<h4>Background</h4>In Niger the prevalence of girl child marriage and low female control over family planning (FP) has resulted in the world's highest adolescent fertility. Male control of FP is associated with intimate partner violence (IPV) and reproductive coercion (RC). We assessed associations of IPV and RC with FP use among married adolescent girls (ages 13-19 years) in Dosso, Niger (<i>N</i> = 1072).<h4>Methods</h4>Multivariable, cross-sectional regression models assessed associations bet ...[more]

PMID: 32382722

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Project description:IntroductionIn 2013, the WHO published the first global and regional estimates on physical and sexual intimate partner violence (IPV) and non-partner sexual violence (NPSV) based on a systematic review of population-based prevalence studies. In this protocol, we describe a new systematic review for the production of updated estimates for IPV and NPSV for global monitoring of violence against women, including providing the baseline for measuring Sustainable Development Goal to eliminate all forms of violence against women and girls.Methods and analysisThe systematic review will update and extend the previous search for population-based surveys (either nationally or subnationally representative) conducted among women aged 15+ years that measured the prevalence of physical, sexual, psychological and physical and/or sexual IPV, NPSV or sexual violence by any perpetrator up to December 2019. Data will be extracted separately for all age groups, setting (urban/rural), partnership status (currently partnered/ever partnered/all women) and recall period (lifetime prevalence/past 12 months). Studies will be identified from electronic searches of online databases of EMBASE, MEDLINE, Global Health and PsycInfo. A search of national statistics office homepages will be conducted for each country to identify reports on population-based, national or subnational studies that include data on IPV or NPSV published outside academic journals. Two reviewers will be involved in quality assessment and data extraction of the review. The review is planned to be updated on a continuous basis. All findings will undergo a country consultation process.Ethics and disseminationFormal ethical approval is not required, as primary data will not be collected. This systematic review will provide a basis and a follow-up tool for global monitoring of the Sustainable Development Goal Target 5.2 on the elimination of all forms of violence against women and girls.Prospero registration numberCRD42017054100.

Project description:ObjectiveThe association between intimate partner violence (IPV) and breastfeeding is unclear. We conducted a systematic review to summarise the evidence of breastfeeding outcomes following exposure to IPV.DesignSystematic review.MethodsWe searched for published studies without study design or language restrictions (up to July 2019) in the following databases: PubMed, Embase, SCOPUS and The Global Health Library. Studies assessing various breastfeeding outcomes (initiation, duration and exclusive breastfeeding) in women exposed to IPV in any form (physical, psychological or sexual) and at any stage (1 year pre-pregnancy, during or post-pregnancy) were included. Two authors independently selected the studies and conducted the quality appraisal by use of the Newcastle-Ottawa Scale. Results were summarised taking precision and quality into account.ResultsA total of 16 studies (participants n=414 393) were included and they adjusted for a total of 48 different confounders. The majority of studies were cross-sectional (n=11) and most studies were judged to be fair/low quality. Four out of seven studies found that IPV exposure shortened breastfeeding duration (adjusted ORs/aORs=0.22 (95% CI: 0.05-0.85), 1.18 (95% CI: 1.01-1.37), 5.92 (95% CI: 1.72-27.98), 1.28 (95% CI: 1.18-1.39)). Further, 5/10 studies found that IPV led to early termination of exclusive breastfeeding (aORs=1.53 (95% CI: 1.01-23.1), 0.83 (95% CI: 0.71-0.96), 1.35 (95% CI: 1.07-1.71), 0.17 (95% CI: 0.07-0.4), 1839 (95% CI: 1.61-2911)) and 2/6 studies found that IPV significantly reduced breastfeeding initiation (aORs=2.00 (95% CI: 1.2-3.3), 0.81 (95% CI: 0.7-0.93)).ConclusionIPV exposure appears to associate negatively with some breastfeeding outcomes. Individual patient data meta-analysis is required to quantify the magnitude of the association for specific IPV-outcome combinations. More high-quality studies and definition of core confounders are warranted.Prospero registration numberCRD42019129353.

Project description:The purpose of this study was to assess via longitudinal analysis whether women's economic empowerment and financial inclusion predicts incident IPV. This prospective study involved analysis of three waves of survey data collected from rural young married women (n = 853 women) in Maharashtra at baseline and 9&18 month follow-ups. This study, which was in the field from 2012 to 2014, was conducted as part of a larger family planning evaluation study unrelated to economic empowerment. Participants were surveyed on economic empowerment, as measured by items on women's income generation and joint decision-making of husband's income, and financial inclusion, as measured by bank account ownership. Women's land ownership and participation in microloan programs were also assessed but were too rare (2-3% reporting) to be included in analyses. Longitudinal regression models assessed whether women's economic empowerment predicted incident IPV at follow-up. At Wave 1 (baseline), one in ten women reported IPV in the past six months; 23% reported income generation; 58% reported having their own money; 61% reported joint control over husband's money, and 10% reported bank ownership. Women's income generation and having their own money did not predict IPV over time. However, women maintaining joint control over their husband's income were at a 60% reduced risk for subsequent incident IPV (AOR = 0.40; 95% CI = 0.18, 0.90), and women gaining joint control over time were at a 70% reduced risk for subsequent incident IPV (AOR = 0.30; 95% CI = 0.13, 0.72), relative to women whose husbands maintained sole control over his income. Women who initiated a new bank account by Wave 3 also had a 56% reduced likelihood of reporting incident IPV in this same wave (AOR = 0.44; 95% CI = 0.22, 0.93), relative to those who maintained no bank account at Waves 1 and 3. These findings suggest that women's joint control over husband's income and her financial inclusion as indicated by bank ownership appear to reduce risk for IPV, whereas her income generation or control over her own income do not. Awareness of and participation in financial inclusion services may help reduce women's risk for IPV in rural India and elsewhere.

Dataset Information

Associations of reproductive coercion and intimate partner violence with overt and covert family planning use among married adolescent girls in Niger.

Publications

Associations of reproductive coercion and intimate partner violence with overt and covert family planning use among married adolescent girls in Niger.

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