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Detrimental effects of intimate partner violence on the nutritional status of children: insights from PDHS 2012-2013.
International Journal of Community Medicine and Public Health. 2018 May; 5(5):1742-1749.Background: Endemicity of intimate partner violence (IPV) against women is established globally. Children are directly dependent on mothers for care and nourishment. Literature has shown inconsistent association between IPV and nutritional status of children, and no nationwide study has been conducted in Pakistan to test this association. Thus, we aimed to do a secondary data analysis on Pakistan Demographic Health Survey (PDHS 2012-13) to explore the association of IPV and the nutritional status of children. Methods: This secondary data analysis was conducted on nationally representative data of PDHS 2012-13. All four provinces, including Islamabad Capital Territory and Gilgit Baltistan districts were taken, and two stage stratified random sampling was performed. The conflict tactics scale (CTS) was used to quantify Intimate Partner Violence (IPV), and its emotional and physical dimensions. Results: This study included mother-child dyads (n=1851) who completed the domestic violence module in PDHS. The lifetime prevalence of intimate partner violence was almost 40% among married women of reproductive age group. About 20% of women reported emotional violence and 2.5% women reported physical violence only. However, 16% of the women reported having suffered from both emotional and physical violence. Women who suffered from emotional violence had children with significantly higher odds of being underweight (OR, 95% CI: 1.57, 1.04-2.36) and stunted (OR, 95% CI: 1.54, 1.05-2.24) respectively. IPV was not found to be significantly associated with occurrence of wasting in children. Conclusions: Policy implications towards this issue call for establishing programmes and laws to protect women and children from the detrimental effects of violence. Provision of initiatives which focus on women autonomy and empowerment via increased access to education and economic opportunities.
Unseen, unheard and unprotected: prevalence and correlates of violence among female sex workers in Mozambique.
Culture, Health & Sexuality. 2018 Nov 19; 16 p.Violence against women, including female sex workers, is a public health concern worldwide. This is the first study in Mozambique to estimate the prevalence of and factors associated with physical and sexual violence against female sex workers. We used data collected from 1,250 women recruited using respondent-driven sampling in the cities of Maputo, Beira and Nampula in 2011–12. Participants were 15 years of age and reported having had sex for money in the preceding six months. Prevalence of physical or sexual violence (defined as being hit or battered or raped or forced to have sex within the last 6 months) ranged from 10.0% to 25.6%. Strangers (37.0%) and acquaintances (31.2%) were reported to be the most frequent perpetrators of sexual violence. Among participants who experienced sexual violence, 65.9% and 87.0% did not seek medical care and police assistance, respectively. Physical or sexual violence was associated with city (adjusted odds ratio [AOR] 2.6 and 2.0 Nampula and Beira vs Maputo), age (AOR 1.9, aged 15–24 years vs aged 25 and older), unprotected sex with last client (AOR 1.6) and self-reported sexually transmitted infections (AOR 2.1). The high prevalence of violence found confirms the need for interventions to mitigate this problem.
Prevalence and correlates of domestic violence in a resettlement colony of union territory of Chandigarh, India.
International Journal of Community Medicine and Public Health. 2018 Jul; 5(7):3079-3083.Background: Domestic violence is not just a problem of the lower and middle classes. Domestic violence is a pervasive problem in India that cuts across age, education, social class and religion. Present study was done with the objectives to study the prevalence of domestic violence issue; to measure different types of domestic violence (i.e. physical, sexual and emotional) ; and to assess the correlation of different socioeconomic factors with occurrence of domestic violence in rural field practice area of Government Medical College and Hospital, Chandigarh. Methods: A cross sectional study was conducted in rural field practice area amongst 800 women of reproductive age group by interview technique after obtaining an informed consent from. The questionnaire was based upon National Family Health Survey-3 questionnaire. The data was fed in Microsoft Excel and analyzed using Epi Info statistical software. Results: The prevalence of any type of domestic violence was 17.75%. Most common type of violence was humiliation, followed by physical violence in the form of slap (14.5%), twist, push, punch and kick. More severe forms like burns, dislocation, cuts were low (1.75%). The prevalence of sexual violence was found to be 1%. Domestic violence was associated with illiteracy in women (p=0.001), low income of women (p<0.001), reserved category of family (p<0.001), alcohol consumption in husband (p<0.001), low income or unemployed husband (p<0.001). No association of domestic violence was found with unemployment in women and illiteracy in husband. Conclusions: It needs more education, empowerment and sensitization in both men and women to change the patriarchal nature of Indian society and to break the culture of silence and tolerance against such heinous crime of inhumanity.
Intimate partner violence experienced by pregnant women availing antenatal care at a rural hospital in South Karnataka.
International Journal of Community Medicine and Public Health. 2018 Aug; 5(8):3548-3552.Background: Intimate partner violence is a global phenomenon with 30% of women having faced physical or sexual violence by a partner in their lifetime. Rural women with poor access to health services and counselling, often suffer in silence. Intimate partner violence during pregnancy has a negative effect on maternal and foetal outcomes. The aims of the study were to estimate the prevalence of intimate partner violence among pregnant women availing antenatal care services in a rural area of South India in current pregnancy and in the past 12 months, and to study the various socio-demographic factors associated with intimate partner violence. Methods: A cross sectional study was done among antenatal women availing services at a rural maternity hospital, using a questionnaire based on NFHS-3, to document physical, emotional and sexual domains of intimate partner violence. Results: Among 150 pregnant women aged 18-29 years, the prevalence of any form of intimate partner violence was 30.7% in the past 12 months before pregnancy (physical 10.7%, sexual 2%, and emotional 26%), and 2.7%. in current pregnancy. Lower educational status of husband and wife, history of alcohol consumption, tobacco usage and unplanned pregnancy were all significantly associated with increased intimate partner violence. Conclusions: Routine antenatal care provides an opportunity to screen women for intimate partner violence, especially those with risk factors like lower level of education, unplanned pregnancy as well as alcohol and tobacco consumption by the husband, which were found to be significantly associated with intimate partner violence in our study.
Associations between Police Harassment and HIV Vulnerabilities among Men Who Have Sex with Men and Transgender Women in Jamaica.
Health and Human Rights. 2017 Dec; 19(2):147-154.Add to my documents.
Expanding the agenda for addressing mistreatment in maternity care: a mapping review and gender analysis.
Reproductive Health. 2018 Aug 28; 15(143):13 p.Background: This paper responds to the global call to action for respectful maternity care (RMC) by examining whether and how gender inequalities and unequal power dynamics in the health system undermine quality of care or obstruct women’s capacities to exercise their rights as both users and providers of maternity care. Methods: We conducted a mapping review of peer-reviewed and gray literature to examine whether gender inequality is a determinant of mistreatment during childbirth. A search for peer-reviewed articles published between January 1995 and September 2017 in PubMed, Embase, SCOPUS, and Web of Science databases, supplemented by an appeal to experts in the field, yielded 127 unique articles. We reviewed these articles using a gender analysis framework that categorizes gender inequalities into four key domains: access to assets, beliefs and perceptions, practices and participation, and institutions, laws, and policies. A total of 37 articles referred to gender inequalities in the four domains and were included in the analysis. Results: The mapping indicates that there have been important advances in documenting mistreatment at the health facility, but less attention has been paid to addressing the associated structural gender inequalities. The limited evidence available shows that pregnant and laboring women lack information and financial assets, voice, and agency to exercise their rights to RMC. Women who defy traditional feminine stereotypes of chastity and serenity often experience mistreatment by providers as a result. At the same time, mistreatment of women inside and outside of the health facility is normalized and accepted, including by women themselves. As for health care providers, gender discrimination is manifested through degrading working conditions, lack of respect for their abilities, violence and harassment,, lack of mobility in the community, lack of voice within their work setting, and limited training opportunities and professionalization. All of these inequalities erode their ability to deliver high quality care. Conclusion: While the evidence base is limited, the literature clearly shows that gender inequality-for both clients and providers-contributes to mistreatment and abuse in maternity care. Researchers, advocates, and practitioners need to further investigate and build upon lessons from the broader gender equality, violence prevention, and rightsbased health movements to expand the agenda on mistreatment in childbirth and develop effective interventions.
Population and Development Review. 2018 Mar; 44(1):63-85.Intimate partner violence (IPV) has severe negative consequences for women’s physical and mental health (Dude 2007; Umberson et al. 1998), for their ability to work and maintain their incomes (Koenig et al. 2003; Johnson and Ferraro 2000; Villarreal 2007; Friedemann-Sánchez and Lovatón 2012), and for the long-term well-being of the children of parents in relationships experiencing violence (Wolfe et al. 2003). These findings have fueled the growth of academic research calling for the incorporation of IPV into development discourses and interventions (Agarwal and Panda 2007; Friedemann-Sánchez and Lovatón 2012). Such calls from academia align with World Bank Group President Jim Yong Kim’s (2014) identification of the “blind spot” that keeps IPV hidden from the development agenda. Kim argues that violence against women is far more than a private matter; it is one that affects “not only them [women], but their families, communities, and economies.” Women’s protection from IPV thus becomes intertwined with parallel notions of women’s status and empowerment and the economic development of countries. Our research is motivated by two strands of IPV literature that often treat women’s economic status and broader gender norms in isolation from each other. For example, bargaining frameworks assume that women’s improved economic or social standing in the household leads to greater power in the relationship, greater ability to influence household decisions and resource distribution (Hoddinott and Haddad 1995; Doss 1996), higher self-esteem, and the ability to leave or threaten to leave relationships that become violent (Friedemann-Sánchez 2006). Yet, recent research (Weitzman 2014) has shown that factors assumed to empower women (e.g., higher education and earnings) are also linked with a higher prevalence of partner abuse when such attainments exceed those of a male partner.While increased bargaining power may reduce women’s risk of partner abuse, such increases in women’s status may also be interpreted as a threat to norms surrounding male-dominated households to which men respond violently. This notion of gender deviance neutralization2 (Goode 1971; Atkinson, Greenstein, and Lang 2005; Weitzman 2014) emphasizes the importance of broader gender ideologies as a crucial factor that can shape and, at times, override women’s individual socioeconomic gains. Using the Peru Demographic and Health Surveys, we run multinomial logistic regressions on household resources and decision-making distributions, as well as known correlates of IPV, to examine women’s likelihood of experiencing violence. We find that women who have higher earnings and higher education than their partners are more likely to experience physical violence. At the same time, women in households where decision-making is shared by both partners are less likely to report physical violence. We suggest that shared decision-making power constitutes a model of gendercooperative partnerships that are linked with lower levels of violence, even in higher-risk households that deviate from gender norms. Our study contributes to disentangling the concepts of gender and empowerment in IPV research. (excerpt)
Breast-feeding counselling mitigates the negative association of domestic violence on exclusive breast-feeding duration in rural Bangladesh. The MINIMat randomized trial.
Public Health Nutrition. 2017 Oct; 20(15):2810-2818.OBJECTIVE: To determine if exclusive breast-feeding counselling modifies the association of experience of any lifetime or specific forms of domestic violence (DV) on duration of exclusive breast-feeding (EBF). DESIGN: In the MINIMat trial pregnant women were randomized to receive either usual health messages (UHM) or usual health messages with breast-feeding counselling (BFC) in eight visits. During pregnancy (30 weeks), lifetime experience of any or specific forms of DV was measured. Infant feeding practice information was collected from 0 to 6 months at 15 d intervals. SETTING: Matlab, Bangladesh. SUBJECTS: Pregnant and postpartum women (n 3186) and their infants. RESULTS: Among women in the UHM group, those who had experienced any lifetime DV exclusively breast-fed for a shorter duration than women who did not experience any lifetime DV (P=0.02). There was no difference, however, in duration of EBF among women in the BFC group based on their experience of any lifetime DV exposure (P=0.48). Using Cox regression analysis, there was an interaction of exposure to any lifetime DV, sexual violence and controlling behaviour, and counselling group with duration of breast-feeding at or before 6 months (P-interaction=0.08). Among the UHM group, experience of any lifetime DV, sexual violence or controlling behaviour was associated with fewer days of EBF (P<0.05). In contrast, among the BFC group, experience of DV was not associated with duration of EBF. CONCLUSIONS: The experience of DV compromises EBF and the support of breast-feeding counselling programmes could assist this vulnerable group towards better infant feeding practices.
African Health Sciences. 2017 Sep; 17(3):681-689.BACKGROUND: Violence by intimate partner during pregnancy has many adverse pregnancy outcomes. Thus, that's why we sought to determine association between intimate partner violence during pregnancy and adverse birth outcomes. METHODS: A facility based cross-sectional study was conducted among 183 recently delivered women from March 31-April 30, 2014 in public health facilities of Hossana Town. The data were collected through structured questionnaire and record review. Women who were not mentally and physically capable of being interviewed and those admitted for abortion were excluded. Ethical clearance was obtained from Jimma University. Logistic regression analysis was employed to determine the association between intimate partner violence and adverse birth outcomes. RESULTS: About 23 % of women experienced intimate partner violence during pregnancy. The result of this study indicated an association of intimate partner violence with low birth weight of the new born (AOR:14.3,95% CI: (5.03, 40.7). Intimate partner violence was not associated with still birth, pre-term birth and Apgar score less than 7 at 5 minutes. CONCLUSION: The findings of this study showed that intimate partner violence during pregnancy was associated with a low birth weight of the new born. Health sectors should train health care providers on how to screen, counsel, treat and follow up abused women.
Development in Practice. 2018; 28(4):574-583.The discourse on domestic violence has steadily moved from solely the realm of private family affairs into the institutional domain, through changing perceptions and the enactment and enforcement of laws. This article aims to understand how women approach institutions and how institutions perceive, translate, and respond to complaints within human rights discourses. The study analysed all cases registered in a family counselling centre in Rajasthan, India, with ten cases then randomly selected for in-depth interviews. The institutions are a catalyst of social change; however, they need to partner with specialists for medical interventions, and network with line departments more effectively to improve social resilience. © 2018 Informa UK Limited, trading as Taylor & Francis Group.
Are men's misogynistic attitudes associated with poor mental health and substance use behaviors? An exploratory study of men in Tijuana, Mexico.
Psychology of Men and Masculinity. 2018; 19(2):314-318.Men's misogynistic attitudes (i.e., dislike or contempt for women) have been shown to be associated with men's perpetration of physical/sexual violence against women and poor health outcomes for women. However, these attitudes have rarely been examined for their influence on men's own health. This article examines the sociodemographic, substance use, and mental health correlates of misogynistic attitudes among a binational sample of men (n = 400) in Tijuana, Mexico, with high-risk substance use and sexual behaviors. We used a six-item scale to measure misogynistic attitudes (a = .72), which was developed specifically for this context. We used descriptive statistics to describe our sample population and the extent to which they hold misogynistic attitudes. Then, using misogynistic attitudes as our dependent variable, we conducted bivariate linear regression and multivariable linear regression to examine the relationship between these attitudes and sociodemographic characteristics, substance use behaviors (i.e., use of alcohol, marijuana, heroin, methamphetamines, cocaine), and mental health (i.e., depression, self-esteem). In the multivariable model, we found significant relationships between misogynistic attitudes and education level, t = -4.34, p < .01; heroin use in the past 4 months, t = 2.50, p = .01; and depressive symptoms, t = 3.37, p < .01. These findings suggest that misogynistic attitudes are linked to poor health outcomes for men, and future research needs to further explore the temporality of these relationships and identify strategies for reducing men's misogynistic attitudes with the ultimate aim of improving the health and well-being of both women and men. © 2017 American Psychological Association.
International Journal of Human Rights. 2018; 1-17.Any attempt to stop cycles of violence requires an understanding of the cultural meanings of impunity, or freedom from consequences. As Cambodia struggles to combat the tide of violence in daily life, at a time when former Khmer Rouge leaders face the Extraordinary Chambers in the Courts of Cambodia (ECCC), this article discusses the cultural underpinnings of impunity in Cambodia. In this ethnographic study, data are gathered from survivors and perpetrators of direct violence (e.g. violence against women and children) and public violence (e.g. land-grabbing). Findings show that some perpetrators ‘remember’ having been victims of violence in a previous incarnation and are reborn as perpetrators, while others, born with particular birthmarks, are prone to impunity. From the Buddhist cultural perspective prevalent in Cambodia, the three ‘unwholesome roots’ – craving, anger, and delusion – poison the perpetrators’ minds and lead them on the ‘road to ruin’, imbuing them with ‘clouded moral vision’ that blinds them and results in a failure of conscience. The study’s findings will add to our understanding of the cultural and psychological footprint of impunity, with implications for the development of culturally responsive strategies to end the cycle of violence. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
The impact of SASA!, a community mobilisation intervention, on women's experiences of intimate partner violence: secondary findings from a cluster randomised trial in Kampala, Uganda.
Journal of Epidemiology and Community Health. 2016 Aug; 70(8):818-25.BACKGROUND: Intimate partner violence (IPV) is a global public health and human rights concern, though there is limited evidence on how to prevent it. This secondary analysis of data from the SASA! Study assesses the potential of a community mobilisation IPV prevention intervention to reduce overall prevalence of IPV, new onset of abuse (primary prevention) and continuation of prior abuse (secondary prevention). METHODS: A pair-matched cluster randomised controlled trial was conducted in 8 communities (4 intervention, 4 control) in Kampala, Uganda (2007-2012). Cross-sectional surveys of community members, 18-49 years old, were undertaken at baseline (n=1583) and 4 years postintervention implementation (n=2532). Outcomes relate to women's past year experiences of physical and sexual IPV, emotional aggression, controlling behaviours and fear of partner. An adjusted cluster-level intention-to-treat analysis compared outcomes in intervention and control communities at follow-up. RESULTS: At follow-up, all types of IPV (including severe forms of each) were lower in intervention communities compared with control communities. SASA! was associated with lower onset of abuse and lower continuation of prior abuse. Statistically significant effects were observed for continued physical IPV (adjusted risk ratio 0.42, 95% CI 0.18 to 0.96); continued sexual IPV (0.68, 0.53 to 0.87); continued emotional aggression (0.68, 0.52 to 0.89); continued fear of partner (0.67, 0.51 to 0.89); and new onset of controlling behaviours (0.38, 0.23 to 0.62). CONCLUSIONS: Community mobilisation is an effective means for both primary and secondary prevention of IPV. Further support should be given to the replication and scale up of SASA! and other similar interventions. TRIAL REGISTRATION NUMBER: NCT00790959. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Intimate partner violence in pregnancy among antenatal attendees at health facilities in West Pokot county, Kenya.
Pan African Medical Journal. 2017; 28:229.Introduction: The objective of this study was to investigate factors contributing to intimate partner violence in pregnancy among antenatal attendees at the health facilities in West Pokot Sub-County. The study was done in West Pokot Sub-County. Methods: Using cross sectional study design, a total of 238 antenatal attendees were systematically sampled for the study. Four focused group discussions and 20 key informant interviews were conducted for qualitative data collection. Qualitative data was consolidated into various themes while bivariate and logistic regression analysis was done to determine factors associated with experience of IPV in the index of pregnancy with P = 0.05 being considered significant. Results: The study found prevalence of overall, physical, psychological and sexual IPV in pregnancy to be 66.9%, 29.9%, 55.8% and 39.2% respectively. After adjusting for confounders, Overall IPV in pregnancy was significantly associated with Alcohol intake by partner (OR 2.116, 95% CI 1.950-2.260, P 0.000) and partner's level of education (OR 1.265, 95% CI 1.079-1.487, P 0.031), while psychological and sexual IPV was significantly associated with age of partner (OR 2.292, 95% CI 2.123-2.722, P 0.007) and age of pregnant women (OR 1.174, 95% CI 1.001-1.397 P 0.049) respectively. The care offered to antenatal attendees experiencing IPV was not in line with WHO guidelines and standard on handling gender based violence cases. Conclusion: The study finding indicates that IPV in pregnancy among antenatal attendees in West Pokot is very high. This unearths the gaps on gender based violence interventions in the maternal and child health programs.
African Journal of AIDS Research. 2017 Dec; 16(4):305-313.Swaziland has the highest HIV prevalence in the world. It is recognised that young women, especially adolescents, are particularly vulnerable to HIV infection and bear a disproportionate burden of HIV incidence. The HIV data from Swaziland show the location of the epidemic, which is particularly high among adolescent girls and young women. This paper is based on research in Swaziland, commissioned because of the perception that large numbers of children were dropping out of the school. It was assumed that these "dropouts" had increased risk of HIV exposure. This study carried out a detailed analysis using the Annual Education Census Reports from 2012 to 2014 produced by the Ministry of Education. In addition, this topic was explored, during fieldwork with key informants in the country. While HIV prevalence rises rapidly among young women in Swaziland, as is the case across most of Southern Africa, the data showed there were few dropouts. This was the case at all levels of education - primary, junior secondary and senior secondary. The major reason for dropping out of primary school was family reasons; and in junior and senior secondary, pregnancy was the leading cause. Swaziland is doing well in terms of getting its children into school, and, for the most part, keeping them there. This paper identifies the students who face increased vulnerability: the limited number of dropouts; repeaters who consequently were "out-of-age for grade"; and orphans and vulnerable children (OVC). The learners who were classified as repeaters and OVC greatly outnumbered the dropouts. We argue, on the basis of these data, for re-focussed attention and the need to develop a method for tracking children as they move across the vulnerable groups. We acknowledge schooling is protective in reducing children's vulnerability to HIV, and Swaziland is on the right track in education, although there are challenges.
Constrained relationship agency as the risk factor for intimate partner violence in different models of transactional sex.
African Journal of AIDS Research. 2017 Dec; 16(4):283-293.Women who engage in transactional sex are more likely to experience intimate partner violence (IPV) and are at higher risk of HIV. However, women engage in transactional sex for a variety of reasons and the precise mechanism linking transactional sex and IPV is not fully understood. We conducted a behavioural survey with a cross-sectional sample of 401 women attending 1 rural and 1 urban public antenatal clinic in Swaziland between February and June 2014. We used structural equation modelling to identify and measure constrained relationship agency (CRA) as a latent variable, and then tested the hypothesis that CRA plays a significant role in the pathway between IPV and transactional sex. After controlling for CRA, receiving more material goods from a sexual partner was not associated with higher levels of physical or sexual IPV and was protective against emotional IPV. CRA was the single largest predictor of IPV, and more education was associated with decreased levels of constrained relationship agency. Policies and interventions that target transactional sex as a driver of IPV and HIV may be more successful if they instead target the broader social landscape that constrains women's agency and drives the harmful aspects of transactional sex.
Influence of peer support on HIV/STI prevention and safety amongst international migrant sex workers: A qualitative study at the Mexico-Guatemala border.
PloS One. 2018; 13(1):e0190787.BACKGROUND: Migrant women engaged in precarious employment, such as sex work, frequently face pronounced social isolation alongside other barriers to health and human rights. Although peer support has been identified as a critical HIV and violence prevention intervention for sex workers, little is known about access to peer support or its role in shaping health and social outcomes for migrant sex workers. This article analyses the role of peer support in shaping vulnerability and resilience related to HIV/STI prevention and violence among international migrant sex workers at the Mexico-Guatemala border. METHODS: This qualitative study is based on 31 semi-structured interviews conducted with international migrant sex workers in the Mexico-Guatemala border communities of Tapachula, Mexico and Tecun Uman and Quetzaltenango, Guatemala. RESULTS: Peer support was found to be critical for reducing social isolation; improving access to HIV/STI knowledge, prevention and resources; and mitigating workplace violence, particularly at the initial stages of migration and sex work. Peer support was especially critical for countering social isolation, and peers represented a valuable source of HIV/STI prevention knowledge and resources (e.g., condoms), as well as essential safety supports in the workplace. However, challenges to accessing peer support were noted, including difficulties establishing long-lasting relationships and other forms of social participation due to frequent mobility, as well as tensions among peers within some work environments. Variations in access to peer support related to country of work, work environment, sex work and migration stage, and sex work experience were also identified. CONCLUSIONS: Results indicate that peer-led and community empowerment interventions represent a promising strategy for promoting the health, safety and human rights of migrant sex workers. Tailored community empowerment interventions addressing the unique migration-related contexts and challenges faced by migrant sex workers should be a focus of future community-based research, alongside promotion of broader structural changes.
Reproductive Health. 2018 Mar 27; 15(1):54.BACKGROUND: The disrespect and abuse of women during the process of childbirth is an emergent and global problem and only few studies have investigated this worrying issue. The objective of the present study was to describe the prevalence of disrespect and abuse of women during childbirth in Pelotas City, Brazil, and to investigate the factors involved. METHODS: This was a cross-sectional population-based study of women delivering members of the 2015 Pelotas birth cohort. Information relating to disrespect and abuse during childbirth was obtained by household interview 3 months after delivery. The information related to verbal and physical abuse, denial of care and invasive and/or inappropriate procedures. Poisson regression was used to evaluate the factors associated with one or more, and two or more, types of disrespectful treatment or abuse. RESULTS: A total of 4275 women took part in a perinatal study. During the three-month follow-up, we interviewed 4087 biological mothers with regards to disrespect and abuse. Approximately 10% of women reported having experienced verbal abuse, 6% denial of care, 6% undesirable or inappropriate procedures and 5% physical abuse. At least one type of disrespect or abuse was reported by 18.3% of mothers (95% confidence interval [CI]: 17.2-19.5); and at least two types by 5.1% (95% CI: 4.4-5.8). Women relying on the public health sector, and those whose childbirths were via cesarean section with previous labor, had the highest risk, with approximately a three- and two-fold increase in risk, respectively. CONCLUSIONS: Our study showed that the occurrence of disrespect and abuse during childbirth was high and mostly associated with payment by the public sector and labor before delivery. The efforts made by civil society, governments and international organizations are not sufficient to restrain institutional violence against women during childbirth. To eradicate this problem, it is essential to 1) implement policies and actions specific for this type of violence and 2) formulate laws to promote the equality of rights between women and men, with particular emphasis on the economic rights of women and the promotion of gender equality in terms of access to jobs and education.
Intimate partner violence and HIV status among ever-married cohabiting Zimbabwean women: An examination of partners' traits.
African Journal of Reproductive Health. 2017 Dec; 21(4):45-54.This study examines the connection between intimate partner violence (IPV) and Human Immunodeficiency Virus status among married and cohabitating women in Zimbabwe using an African feminist framework. Stata 13.0 was used to analyze data from the 2010-2011 Zimbabwe Demographic and Health Survey, which used a national probability sample of households in the country of Zimbabwe. This study used logistic regression to analyze the 2,830 ever-married or cohabitating women who also answered the violence and spousal traits questionnaire as well as provided blood samples. The logistic regression revealed that women who had experienced any type of intimate partner violence (odds ratio=1.29, CI [1.00, 1.67]) or broken bones (odds ratio=2.39, CI [1.19, 4.77]) were more likely to be HIV positive; relative to those with bruises bruises (odds ratio=- .64 CI [.41, .99]) were less likely. Women with partners who are trackers (odds ratio=1.28, CI [1.04, 1.59]) were more likely to be HIV positive. Patriarchal, hypermasculist culture, shown through violence against women, contributes to the likelihood of HIV in wives and partners. A cultural shift at the highest levels may help to prevent IPV and reduce the spread of HIV.
Common Crime and Domestic Violence Victimization of Older Chinese in Urban China: The Prevalence and Its Impact on Mental Health and Constrained Behavior.
Journal of Interpersonal Violence. 2018; 33(6):889-914.This article examines the prevalence of victimization among older Chinese living in urban China and its psychological and behavioral impacts. A representative sample of 453 older adults aged 60 or above was recruited from Kunming, the People’s Republic of China, using multistage sampling method. Participants were individually interviewed on their demographic characteristics, experience of common crime and domestic violence victimization, fear of common crime and domestic violence, mental health, and constrained behavior. Results showed that 254 participants (56.1%) reported one or more types of common crime and 21 (4.6%) reported experiencing domestic violence in the past. Seventeen participants (3.8%) reportedly experienced both common crime and domestic violence victimization. There was no gender difference in the overall incidence of victimization but in some subtypes. Regression analyses indicated that past experience of common crime victimization was significantly associated with greater fear of common crime (ß =.136, p =.004), poorer mental health (ß =.136, p =.003), and more constrained behavior (ß =.108, p =.025). Fear of common crime predicted increased constrained behavior (ß =.240, p <.001) independent of gender, age, education, household finances, living arrangement, and physical health. Domestic violence victimization was not significant in predicting poor mental health and constrained behavior but was significant in predicting fear of domestic violence (ß =.266, p <.001), which was related to poorer mental health (ß =.102, p =.039). The study suggests the importance of taking older people’s risk and experience of victimization into consideration in gerontological research, practice, and policymaking. © 2017, © The Author(s) 2017.
A qualitative approach to understand antiretroviral therapy (ART) adherence for refugees living in Nakivale Refugee Settlement in Uganda.
Conflict and Health. 2018; 12(1)Background: Refugees living with HIV in sub-Saharan Africa suffer unique hardships that may increase their vulnerability to interruptions in antiretroviral therapy (ART). Methods: To investigate refugees' experiences adhering to ART, we conducted inperson interviews with refugees on ART (n = 73) and HIV clinic staff (n = 4) in Nakivale Refugee Settlement in southwest Uganda from March to July 2011. Three analysts used a conventional content analysis approach to evaluate these data. Results: Refugees described profound motivation to adhere to ART and employed adherence strategies to facilitate success despite the austere setting. However, refugees spoke of specific hardships living in Nakivale that served as barriers to ART adherence, including difficulty accessing clinic when ill, food insecurity, drug stockouts, and violence and unrest in the settlement. For some refugees, need for ART inextricably linked them to the HIV clinic and prevented them from transitioning permanently away from the settlement. Conclusions: By learning about refugees' experiences we can design informed interventions to enhance ART adherence, thus minimizing morbidity and mortality, preventing transmission of HIV, and supporting refugees' abilities to move freely toward repatriation, resettlement or integration in their host country. © 2018 The Author(s).
Social Structure, Social Learning, and the Severity of Physical Intimate Partner Violence Against Women in Nigeria.
Journal of Interpersonal Violence. 2018 Mar 1; 886260518764384.Using the Nigerian Demographic and Health Survey (NDHS) of 2013, this study applies the social structure (feminist) and social learning perspective in understanding the severity of physical intimate partner violence (IPV) in Nigeria. About 26,403 married women were analyzed from the 2013 NDHS data. Multinomial regression was used to analyze variables that capture the social structural and social learning perspectives in relation to women's experience of minor and severe physical IPV. The study revealed that primary and secondary educational attainment, and being employed predicted severe physical IPV victimization. Alcohol consumption by the respondents' spouses, being a victim of childhood abuse, and witnessing IPV between parents predicted severe physical IPV. The finding of this study implies that experiences of IPV take place within a sociocultural context that shapes the social realities of the average Nigerian woman.
Open Access Journal of Contraception. 2018 Jan 25; 9:21-28.Background: The nonuse of family planning methods remains a major public health concern in the low-and-middle-income countries, especially due to its impact on unwanted pregnancy, high rate of abortion, and transmission of sexually transmitted diseases. Various demographic and socioeconomic factors have been reported to be associated with the nonuse of family planning methods. In the present study, we aimed at assessing the influence of domestic violence (DV) on contraceptive use among ever married women in Nigeria. Methods: Data on 22,275 women aged between 15 and 49 years were collected from the most recent Nigeria Demographic and Health Survey conducted in 2013. The outcome variable was contraceptive utilization status, and the main exposure variable was DV, which was assessed by the self-reported experience of physical and psychological abuse. Complex survey method was employed to account for the multistage design of the survey. Data analyses were performed by using bivariate and multivariable techniques. Results: The mean age of the participants was 31.33±8.26. More than four fifths (84%) of the participants reported that they were not using any contraceptive methods at all. Lifetime prevalence of psychological and physical abuse was, respectively, 19.0% (95% CI =18.0–20.1) and 14.1% (95% CI =13.3–14.9). Women who reported physical abuse were 28% (adjusted odds ratio [AOR] =1.275; 95% CI =1.030–1.578), and those reported both physical and psychological abuse had 52% (AOR =1.520; 95% CI =1.132–2.042) higher odds of not using any contraception. Conclusion: The rate of contraception nonuse was considerably high and was found to be significantly associated with DV. Thus, the high prevalence of DV may compromise the effectiveness of the family planning programs in the long run. Evidence-based intervention strategies should be developed to protect the health and reproductive rights of the vulnerable women and to reduce DV by giving the issue a wider recognition in public policy making.
[Obstetric violence in public maternity wards of the state of Tocantins] Violência obstétrica em maternidades públicas do estado do Tocantins.
Estudos Feministas. 2018 Jan-Apr; 26(1):1-11.This article presents the results of a survey conducted in 14 public maternity wards of the State of Tocantins, where 56 women were interviewed by means of a semi-structured interview. The study aimed to identify women’s perceptions about violence in the obstetric delivery process. The perception of women about obstetric violence appeared to be related to the lack of quality and reception in care, highlighting the occurrence of various expressions of obstetric violence such as neglect, physical, verbal, psychological violence. A breach in important regulations, the non-utilization of recommendations based on scientific evidence and the breach of the main rights of parturient women were found, setting the magnitude of the violence and the need for improving obstetric services.
[Gender violence In Ecuador: a study about university students] La violencia de género em Ecuador: un estudio sobre los universitarios.
Estudos Feministas. 2017 Sep-Dec; 25(3):1313-1327.Several of the Latin American countries present some of the highest figures in the world on gender violence: historical, cultural, political and socio-economic circumstances strongly determine the construction of the imaginary where gender supremacy prevails, such as in Ecuador, a context in which, according to official figures, six out of ten women are victims of some kind of violence. In this article, we present the results of a project comprising almost three thousand surveys from a reference group of university students. Broadly speaking, there has been a lack of awareness –especially among men– of the complexity due to the phenomenon of violence, as well as a certain tolerance towards this type of social epidemic. Therefore, institutional authorities should intensify strategic communication campaigns to promote an erosion of the symbolic factors that motivate the persistence of a residual traditionalism in this significant epicenter of the Andean culture.