尼泊尔已婚妇女的粮食不安全和亲密伴侣暴力问题。
Food insecurity and intimate partner violence among married women in Nepal.
机构信息
University of California, San Francisco, California, USA.
Harvard University, Cambridge, Massachusetts, USA.
出版信息
J Glob Health. 2019 Jun;9(1):010412. doi: 10.7189/jogh.09.010412.
BACKGROUND
Intimate Partner Violence (IPV) is an important public health concern globally, including in Nepal. Food insecurity (being without reliable access to a sufficient quantity of affordable, nutritious food) has been associated with IPV, but no known studies have explored this relationship in South Asia, or Nepal specifically. Women's level of empowerment is an important factor to consider when understanding the relationship between food insecurity and IPV.
METHODS
Using data from the 2011 Nepal Demographic and Health Survey, we explore the relationship between different levels of food insecurity (none, mild, moderate, severe) and three types of IPV: physical, sexual and emotional. In a second set of models we adjust for indicators of women's empowerment. We use multi-variable logistic regression to test for an association between these factors, adjusting for individual and household level demographic variables.
FINDINGS
About half of married women in our sample experience food insecurity and approximately 10% of women experienced each of the three different types of IPV in the past 12 months: emotional, sexual and physical. Food insecurity is significantly associated with increased odds of experiencing emotional (odds ratio OR = 1.75 95% confidence interval CI = 1.06-2.77 for severe food insecurity) or physical (OR = 2.48, 95% CI = 1.52-4.04 for severe food insecurity) IPV, but not sexual IPV, after adjusting for individual and household level demographic variables. After adjusting for empowerment related factors, this relationship still holds, although it is somewhat attenuated. Women's level of household decision-making power is significantly associated with higher odds of emotional, sexual and physical IPV, and whether she lives with her in-laws is protective against emotional IPV.
CONCLUSIONS
Among married women in Nepal, being food insecure is associated with higher odds of some types of IPV, specifically emotional and physical IPV. Accounting for women's level of empowerment explains some of the relationship between food insecurity and IPV. It is essential that interventions to prevent IPV address household stressors such as food insecurity among married, Nepalese women, perhaps through cross-sectoral approaches. Such structural interventions are likely to reduce IPV for married women across South Asia who live in a similar levels of gender discrimination and food insecurity.
背景
亲密伴侣暴力（IPV）是一个重要的全球公共卫生问题，包括在尼泊尔。粮食不安全（无法可靠地获得足够数量的负担得起的营养食品）与 IPV 有关，但没有已知的研究探索过南亚或尼泊尔的这种关系。妇女的赋权程度是理解粮食不安全与 IPV 之间关系时需要考虑的一个重要因素。
方法
我们使用 2011 年尼泊尔人口与健康调查的数据，探讨了不同程度的粮食不安全（无、轻度、中度、重度）与三种类型的 IPV（身体、性和情感）之间的关系。在第二组模型中，我们调整了妇女赋权的指标。我们使用多变量逻辑回归来测试这些因素之间的关联，同时调整了个人和家庭层面的人口变量。
发现
我们样本中约有一半已婚妇女经历粮食不安全，约有 10%的妇女在过去 12 个月中经历了三种不同类型的 IPV：情感、性和身体。粮食不安全与经历情感（严重粮食不安全的比值比 [OR] = 1.75，95%置信区间 [CI] = 1.06-2.77）或身体（严重粮食不安全的 OR = 2.48，95%CI = 1.52-4.04）IPV 的几率增加显著相关，但与性 IPV 无关，调整了个人和家庭层面的人口变量后仍然如此。调整赋权相关因素后，这种关系仍然存在，尽管有所减弱。妇女在家庭中的决策能力与更高的情感、性和身体 IPV 几率显著相关，而与公婆同住则可预防情感 IPV。
结论
在尼泊尔已婚妇女中，粮食不安全与某些类型的 IPV（特别是情感和身体 IPV）的几率增加有关。考虑到妇女的赋权程度，可以解释粮食不安全与 IPV 之间的部分关系。预防 IPV 的干预措施必须解决已婚尼泊尔妇女面临的家庭压力源，例如粮食不安全问题，也许可以通过跨部门的方法来解决。这种结构性干预措施可能会降低生活在类似性别歧视和粮食不安全程度的南亚已婚妇女的 IPV 发生率。
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