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The magnitude of intimate partner violence during pregnancy in Eldoret, Kenya: exigency for policy action.

ABSTRACT: Intimate partner violence (IPV) is sexual, psychological and physical coercive acts used against persons by intimate partners. When IPV occurs during pregnancy (IPVp), it can result in adverse maternal and pregnancy outcomes. No policy nor practice direction exists to address the rates and risk factors of IPVp in Kenya. Determining the prevalence, types and determinants of IPVp in Western Kenya would aid in the identification of pregnant women affected by and/or at risk of IPVp, as well as informing the development of policy, practices and programmes to support preventive interventions. In this cross-sectional study of 369 women who had given birth at Moi Teaching and Referral Hospital, participants were recruited using systematic sampling and data collected via structured questionnaires adopted from the WHO Violence Against Women Instrument. Associations were made in relation to physical or sexual violence and psychological violence. Logistic regression was used to assess the association between determinants and occurrence of IPVp. The overall prevalence of IPVp was 34.1%. Prevalence of physical or sexual violence was 22.8%. Psychological violence emerged as the most common (27.4%) form of IPVp. A lower than tertiary level of education and previous experience of IPV were individually associated with physical/sexual IPVp, whereas psychological IPVp was associated with previous experience of IPV and was prevented by the intimate partner having formal employment. Preterm birth rates were found to be higher than the country's rates. The prevalence rates of IPVp are high in Western Kenya. Strategies that address the promotion of respectful, nonviolent relationships and that interrupt the development of risk factors are required. Policies (clinical guidelines) targeting prevention of IPVp and screening and the identification of at-risk women and survivors of IPVp are needed urgently. Primary prevention through interrupting the occurrence of predisposing factors is key in addressing IPVp.

SUBMITTER: Luhumyo L

PROVIDER: S-EPMC7751018 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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The magnitude of intimate partner violence during pregnancy in Eldoret, Kenya: exigency for policy action.

Luhumyo Loice L Mwaliko Emily E Tonui Philliph P Getanda Amos A Hann Katrina K

Health policy and planning 20201101 Supplement_1

Intimate partner violence (IPV) is sexual, psychological and physical coercive acts used against persons by intimate partners. When IPV occurs during pregnancy (IPVp), it can result in adverse maternal and pregnancy outcomes. No policy nor practice direction exists to address the rates and risk factors of IPVp in Kenya. Determining the prevalence, types and determinants of IPVp in Western Kenya would aid in the identification of pregnant women affected by and/or at risk of IPVp, as well as infor ...[more]

PMID: 33165585

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Project description:Background: Intimate partner violence (IPV) during pregnancy can lead to negative consequences for both the mother and offspring. Although IPV is recognized as a worldwide public health issue, its prevalence is considered to be underestimated because cases are likely underreported, suggesting that there might be unmeasured IPV. The aim of this study was to develop an instrument to detect IPV in pregnant women. Methods: A total of 6,590 women in Aichi prefecture, Japan, who took part in a 3 or 4 month infant health checkup program, participated in the study. Questionnaires assessing history of IPV during pregnancy (physical abuse and verbal abuse), maternal characteristics, partner's characteristics, and household characteristics were mailed to women before, or distributed at, the checkup. Women returned the questionnaires to the checkup sites or mailed them back to the health centers. A prediction model for history of IPV was then generated using potential risk factors selected based on the literature. Results: Among 6,530 women who responded to either question on IPV during pregnancy (response rate = 67.3%), the rate of participants who experienced any IPV during pregnancy was 11.1% (physical IPV = 1.2%; verbal IPV = 10.8%). Multiple logistic regression analyses showed that maternal age (<25 years old), multiparity, history of artificial abortion, negative feelings when the pregnancy was confirmed (e.g., confused), having no one to provide support during pregnancy, having relationship problems with their partner, paternal smoking during pregnancy, and difficult financial status were associated with any abuse from the partner. Based on the analysis, the Intimate Partner Violence during Pregnancy Instrument (IPVPI) was developed, comprising of eight questions to detect unmeasured IPV in pregnant women, and showed moderate predictive power (area under receiver operating characteristic curve = 0.719, 95% confidence interval: 0.698 to 0.740) ranging from 0 to 16 with a cut-off point of 2 (sensitivity = 79.5%, specificity = 47.1%). Conclusion: The IPVPI, which allows to ask indirect questions rather that asking directly about experience of IPV, might be helpful to detect unmeasured IPV in pregnant women in fields of primary healthcare and obstetrics. Further research longitudinal studies are needed to improve the sensitivity and specificity of the IPVPI.

Project description:BackgroundIntimate partner violence (IPV) is a significant global public health issue. The consistent evidence that alcohol use by one or both partners contributes to the risk and severity of IPV suggests that interventions that reduce alcohol consumption may also reduce IPV. This study sought to review the evidence for effects on IPV of alcohol interventions at the population, community, relationship and individual levels using the World Health Organization ecological framework for violence.MethodsEleven databases including Medline, PsycINFO, CINAHL and EMBASE were searched for English-language studies and grey literature published 1 January 1992 - 1 March 2013 investigating whether alcohol interventions/policies were associated with IPV reduction within adult (? 18) intimate relationships. Eleven studies meeting design criteria for attributing effects to the intervention and ten studies showing mediation of alcohol consumption were included in the review. The heterogeneity of study designs precluded quantitative meta analysis; therefore, a critical narrative approach was used.ResultsPopulation-level pricing and taxation studies found weak or no evidence for alcohol price changes influencing IPV. Studies of community-level policies or interventions (e.g., hours of sale, alcohol outlet density) showed weak evidence of an association with IPV. Couples-based and individual alcohol treatment studies found a relationship between reductions in alcohol consumption and reductions in IPV but their designs precluded attributing changes to treatment. Randomized controlled trials of combined alcohol and violence treatment programs found some positive effects of brief alcohol intervention as an adjunct to batterer treatment for hazardous drinking IPV perpetrators, and of brief interventions with non-dependent younger populations, but effects were often not sustained.ConclusionsDespite evidence associating problematic alcohol use with IPV, the potential for alcohol interventions to reduce IPV has not been adequately tested, possibly because studies have not focused on those most at risk of alcohol-related IPV. Research using rigorous designs should target young adult populations among whom IPV and drinking is highly prevalent. Combining alcohol and IPV intervention/policy approaches at the population, community, relationship and individual-level may provide the best opportunity for effective intervention.

Project description:BackgroundIntimate partner violence (IPV) around the time of pregnancy is a widespread global health problem with many negative consequences. Nevertheless, a lot remains unclear about which interventions are effective and might be adopted in the perinatal care context.ObjectiveThe objective is to provide a clear overview of the existing evidence on effectiveness of interventions for IPV around the time of pregnancy.MethodsFollowing databases PubMed, Web of Science, CINAHL and the Cochrane Library were systematically searched and expanded by hand search. The search was limited to English peer-reviewed randomized controlled trials published from 2000 to 2013. This review includes all types of interventions aiming to reduce IPV around the time of pregnancy as a primary outcome, and as secondary outcomes to enhance physical and/or mental health, quality of life, safety behavior, help seeking behavior, and/or social support.ResultsWe found few randomized controlled trials evaluating interventions for IPV around the time of pregnancy. Moreover, the nine studies identified did not produce strong evidence that certain interventions are effective. Nonetheless, home visitation programs and some multifaceted counseling interventions did produce promising results. Five studies reported a statistically significant decrease in physical, sexual and/or psychological partner violence (odds ratios from 0.47 to 0.92). Limited evidence was found for improved mental health, less postnatal depression, improved quality of life, fewer subsequent miscarriages, and less low birth weight/prematurity. None of the studies reported any evidence of a negative or harmful effect of the interventions.Conclusions and implicationsStrong evidence of effective interventions for IPV during the perinatal period is lacking, but some interventions show promising results. Additional large-scale, high-quality research is essential to provide further evidence about the effect of certain interventions and clarify which interventions should be adopted in the perinatal care context.

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The magnitude of intimate partner violence during pregnancy in Eldoret, Kenya: exigency for policy action.

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The magnitude of intimate partner violence during pregnancy in Eldoret, Kenya: exigency for policy action.

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