Dataset Information

Bayesian semi-parametric spatial modelling of intimate partner violence in Namibia using 2013 Demographic Health Survey Data.

ABSTRACT:

Background

Intimate partner violence (IPV) is an important public health problem with health and socioeconomic consequences and is endemic in Namibia. Studies assessing risk factors for IPV often use logistic and Poisson regression without geographical location information and spatial effects. We used a Bayesian spatial semi-parametric regression model to determine the risk factors for IPV in Namibia; assess the non-linear effects of age difference between partners and determine spatial effects in the different regions on IPV prevalence.

Methods

We used the couples' dataset of the 2013-2014 Namibia Demographic and Health Survey (DHS) obtained on request from Measure DHS. The DHS domestic violence module included 2226 women. We generated a binary variable measuring IPV from the questions "ever experienced physical, sexual or emotional violence?" Covariates included respondent's educational level, age, couples' age difference, place of residence and partner's educational level. All estimation was done with the full Bayesian approach using R version 3.5.2 implementing the R2BayesX package.

Results

IPV country prevalence was 33.3% (95% CI = 30.1-36.5%); Kavango had the highest [50.6% (95% CI = 41.2-60.1%)] and Oshana the lowest [11.5% (95% CI = 3.2-19.9%)] regional prevalence. IPV prevalence was highest among teenagers [60.8% (95% CI = 36.9-84.7%)]). The spatial semi-parametric model used for adjusted results controlled for regional spatial effects, respondent's age, age difference, respondent's years of education, residence, wealth, and education levels. Women with higher education were 50% less likely to experience IPV [aOR: 0.46, 95% CI = 0.23-0.87]. For non-linear effects, the risk of IPV was high for women ≥ 5 years older or ≥ 25 years younger than their partners. Younger and older women had higher risks of IPV than those between 25 and 45 years. For spatial variation of IPV prevalence, northern regions had low spatial effects while western regions had very high spatial effects.

Conclusion

The prevalence of IPV among Namibia women was high especially among teenagers, with higher educational levels being protective. The risk of IPV was lower in rural than urban areas and higher with wide partner age differences. Interventions and policies for IPV prevention in Namibia are needed for couples with wide age differences as well as for younger women, women with lower educational attainment and in urban and western regions.

SUBMITTER: Ojifinni O

PROVIDER: S-EPMC8340378 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundIntimate partner violence (IPV) remains a global public health concern for both men and women. Spatial mapping and clustering analysis can reveal subtle patterns in IPV occurrences but are yet to be explored in Rwanda, especially at a lower small-area scale. This study seeks to examine the spatial distribution, patterns, and associated factors of IPV among men and women in Rwanda.MethodsThis was a secondary data analysis of the 2019/2020 Rwanda Demographic and Health Survey (RDHS) individual-level data set for 1947 women aged 15-49 years and 1371 men aged 15-59 years. A spatially structured additive logistic regression model was used to assess risk factors for IPV while adjusting for spatial effects. The district-level spatial model was adjusted for fixed covariate effects and was implemented using a fully Bayesian inference within the generalized additive mixed effects framework.ResultsIPV prevalence amongst women was 45.9% (95% Confidence interval (CI): 43.4-48.5%) while that for men was 18.4% (95% CI: 16.2-20.9%). Using a bivariate choropleth, IPV perpetrated against women was higher in the North-Western districts of Rwanda whereas for men it was shown to be more prevalent in the Southern districts. A few districts presented high IPV for both men and women. The spatial structured additive logistic model revealed higher odds for IPV against women mainly in the North-western districts and the spatial effects were dominated by spatially structured effects contributing 64%. Higher odds of IPV were observed for men in the Southern districts of Rwanda and spatial effects were dominated by district heterogeneity accounting for 62%. There were no statistically significant district clusters for IPV in both men or women. Women with partners who consume alcohol, and with controlling partners were at significantly higher odds of IPV while those in rich households and making financial decisions together with partners were at lower odds of experiencing IPV.ConclusionCampaigns against IPV should be strengthened, especially in the North-Western and Southern parts of Rwanda. In addition, the promotion of girl-child education and empowerment of women can potentially reduce IPV against women and girls. Furthermore, couples should be trained on making financial decisions together. In conclusion, the implementation of policies and interventions that discourage alcohol consumption and control behaviour, especially among men, should be rolled out.

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.