Ahmad Jaleel, Khan M E, Mozumdar Arupendra, Varma Deepthi S
1 Population Council, New Delhi, India.
2 University of Florida, Gainesville, FL, USA.
J Interpers Violence. 2016 Nov;31(19):3111-3128. doi: 10.1177/0886260515584341. Epub 2016 Sep 29.
This study explores the prevalence of different forms of domestic violence and their impact on women's reproductive health behavior in rural Uttar Pradesh (UP), India. Data were collected as a part of a large household survey carried out in 2009-2010. A multistage stratified systematic sampling design was used. A total of 4,223 married women aged 15 to 49 years and 2,274 husbands of these women were interviewed. Data were analyzed using bivariate and multivariate analyses. More than one third of married women in rural UP had experienced one or more forms of violence, such as verbal abuse, physical manhandling, and sexual abuse by their spouse. Nearly 47% of the women had experienced some form of violence during their last pregnancy. Significant associations were found between violence and incorrect reproductive health behaviors, pregnancy complications, poor birth preparedness, poor likelihood of institutional delivery, limited postnatal care, and limited spousal communication for family planning. After controlling for socio-economic variables in multivariate analysis, only pregnancy complications (odds ratio [OR] = 1.62, 95% confidence interval [CI] = [1.40, 1.85]) and lack of delivery preparedness (OR = 0.79, 95% CI = [0.68, 0.93]) were found to be significantly associated with violence. Husband's attitude and reporting of violence by their wives in different situations were not significantly associated. This study provides evidence of the association of violence on the reproductive health behavior of married women in rural India. The results argue for frontline health workers to identify and counsel pregnant women experiencing violence during antenatal check-up to reduce maternal morbidity and mortality.
本研究探讨了印度北方邦（UP）农村地区不同形式家庭暴力的流行情况及其对妇女生殖健康行为的影响。数据收集于2009 - 2010年开展的一项大型家庭调查。采用了多阶段分层系统抽样设计。共对4223名年龄在15至49岁的已婚妇女及其2274名丈夫进行了访谈。数据采用双变量和多变量分析方法进行分析。北方邦农村地区超过三分之一的已婚妇女曾经历过一种或多种形式的暴力，如配偶的言语虐待、身体暴力和性虐待。近47%的妇女在其上次怀孕期间曾经历过某种形式的暴力。研究发现，暴力与不正确的生殖健康行为、妊娠并发症、分娩准备不足、机构分娩可能性低、产后护理有限以及计划生育方面配偶间沟通有限之间存在显著关联。在多变量分析中控制了社会经济变量后，仅发现妊娠并发症（优势比[OR]=1.62，95%置信区间[CI]=[1.40, 1.85]）和分娩准备不足（OR = 0.79，95% CI = [0.68, 0.93]）与暴力显著相关。丈夫的态度与妻子在不同情况下报告暴力情况之间无显著关联。本研究为印度农村地区暴力与已婚妇女生殖健康行为之间的关联提供了证据。研究结果表明，一线卫生工作者应在产前检查时识别并为遭受暴力的孕妇提供咨询，以降低孕产妇发病率和死亡率。
