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洪都拉斯亲密伴侣暴力作为产前护理服务利用情况的预测因素

Intimate partner violence as a predictor of antenatal care service utilization in Honduras.

作者信息

Sebert Kuhlmann Anne K, Foggia Janine, Fu Qiang, Sierra Manuel

机构信息

College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, United States of America.

Departamento de Salud Pública, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Francisco Morazán, Honduras.

出版信息

Rev Panam Salud Publica. 2017 Aug 21;41:e104. doi: 10.26633/RPSP.2017.104.

Abstract

OBJECTIVE

To describe the relationship between exposure to physical and/or sexual intimate partner violence (IPV) and indicators of antenatal care (ANC) service utilization among Honduran women of reproductive age.

METHODS

Data from the 2011-2012 Honduras Demographic and Health Survey were analyzed to describe the relationship between self-reported exposure to IPV and two ANC outcomes: (1) sufficient ANC visits (defined by the Honduran Ministry of Health as five or more visits) and (2) early ANC initiation (within the first trimester). Multiple logistic regression was used to estimate effects of physical and sexual IPV on the outcomes, controlling for women's age, education, literacy, residence, household size, religion, parity, wealth, husband's age, and husband's education.

RESULTS

Of women who were married, had at least one living child 5 years or younger, and completed the IPV module (N = 6 629), 13.5% of them reported any physical IPV, and 4.1% reported both physical and sexual IPV. There was no significant association between IPV and early ANC; however, a significant relationship between IPV and sufficient ANC was found. Women who experienced any physical IPV (adjusted odds ratios (aOR) = 1.25; 95% confidence interval (CI): 1.00-1.56) or sexual IPV (aOR = 1.53; 95% CI: 1.08-2.16) were, respectively, 25% and 53% more likely to receive insufficient ANC.

CONCLUSIONS

Honduras has one of highest rates of interpersonal violence of any nation in the world. In Honduras, IPV is a contributor to this broader category of interpersonal violence as well as a risk factor for insufficient ANC. Our findings suggest that universal IPV screening during ANC as well as future initiatives aimed at reducing IPV might improve ANC utilization in the country.

摘要

目的

描述洪都拉斯育龄妇女遭受身体和/或性方面的亲密伴侣暴力(IPV)与产前保健(ANC)服务利用指标之间的关系。

方法

对2011 - 2012年洪都拉斯人口与健康调查数据进行分析,以描述自我报告的IPV暴露与两个ANC结果之间的关系:(1)足够的ANC就诊次数(洪都拉斯卫生部定义为五次或更多次就诊)和(2)早期开始ANC(在孕早期内)。使用多元逻辑回归来估计身体和性方面的IPV对这些结果的影响,并控制妇女的年龄、教育程度、识字率、居住地点、家庭规模、宗教信仰、生育次数、财富状况、丈夫年龄和丈夫教育程度。

结果

在已婚、至少有一个5岁或以下在世子女且完成IPV模块调查的妇女中(N = 6629),13.5%报告遭受过任何身体方面的IPV,4.1%报告同时遭受过身体和性方面的IPV。IPV与早期ANC之间无显著关联;然而,发现IPV与足够的ANC之间存在显著关系。遭受过任何身体方面IPV的妇女(调整后的优势比(aOR)= 1.25;95%置信区间(CI):1.00 - 1.56)或性方面IPV的妇女(aOR = 1.53;95%CI:1.08 - 2.16)接受不足ANC服务的可能性分别高出25%和53%。

结论

洪都拉斯是世界上人际暴力发生率最高的国家之一。在洪都拉斯,IPV是这种更广泛的人际暴力类型的一个促成因素,也是ANC不足的一个风险因素。我们的研究结果表明,在ANC期间进行普遍的IPV筛查以及未来旨在减少IPV的举措可能会改善该国的ANC服务利用情况。

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