Suaahara II, Helen Keller International Nepal, Patan, Lalitpur, Nepal.
Suaahara II, Care International, Lalitpur, Nepal.
BMC Womens Health. 2020 Jun 17;20(1):127. doi: 10.1186/s12905-020-00991-x.
Malnutrition among women in Nepal persists as a major public health burden. Global literature suggests that domestic violence may have a negative impact on women's nutritional status. The contribution of intimate partner violence (IPV) to increased stress levels, poor self-care including the consumption of less food and, in turn, malnutrition has been documented. However, there is little empirical evidence on IPV and its relationship with women's nutritional status in Nepal and thus, this paper assesses these associations.
We used data on non-pregnant married women (n = 3293) from the 2016 Nepal Demographic and Health Survey (NDHS). The primary exposure variable was whether the women had ever experienced physical, sexual, or emotional violence or controlling behaviours by a current or former partner, based on her responses to the NDHS domestic violence questions. The primary outcome variables were three indicators of malnutrition: under-weight (BMI < 18.5), over-weight (BMI > 25), and anemia (Hb < 11.0 g dL). We used logistic and multinomial regression models, adjusted for potential socio-demographic and economic confounders, as well as clustering, to examine associations between IPV exposure and malnutrition.
Approximately 44% of women had experienced at least one of the four types of IPV. Among them, around 16, 25%. and 44% were underweight, overweight, or anemic, respectively, compared to 13, 29, and 35% of women never exposed to IPV. We did not find any associations between underweight and any of the four types of IPV. Overweight was associated with physical violence (adjusted RRR = 0.67, P < 0.01, CI = 0.50-0.88) and severe physical violence (adjusted RRR = 0.53, P < 0.05, CI = 0.32-0.88) Controlling behaviors were associated with anemia (adjusted RRR = 1.31, P < 0.01, CI = 1.11-1.54).
Among married Nepalese women, physical violence appears to be a risk factor for one's weight and controlling behaviors for one's anemia status. Additional, rigorous, mixed-methods research is needed to understand the reporting of IPV and what relationships do or do not exist between IPV experience and nutrition both in Nepal and in other settings.
尼泊尔女性的营养不良仍然是一个主要的公共卫生负担。全球文献表明，家庭暴力可能对妇女的营养状况产生负面影响。有文献记录表明，亲密伴侣暴力（IPV）会导致压力水平升高、自我护理不良，包括减少食物摄入，从而导致营养不良。然而，尼泊尔关于 IPV 及其与女性营养状况之间关系的实证证据很少，因此，本文评估了这些关联。
我们使用了 2016 年尼泊尔人口与健康调查（NDHS）中关于非孕妇已婚妇女（n=3293）的数据。主要暴露变量是妇女是否曾经历过身体、性或情感暴力，或现任或前任伴侣的控制行为，基于她对 NDHS 家庭暴力问题的回答。主要的营养不良指标有三个：体重过轻（BMI<18.5）、超重（BMI>25）和贫血（Hb<11.0 g/dL）。我们使用逻辑回归和多项回归模型，调整了潜在的社会人口和经济混杂因素以及聚类，以检查 IPV 暴露与营养不良之间的关联。
约 44%的妇女经历过至少一种四种类型的 IPV。其中，约 16%、25%和 44%的妇女体重过轻、超重或贫血，而从未经历过 IPV 的妇女分别为 13%、29%和 35%。我们没有发现体重过轻与四种类型的 IPV 中的任何一种之间存在关联。超重与身体暴力（调整后的相对危险比[RRR]=0.67，P<0.01，CI=0.50-0.88）和严重身体暴力（调整后的 RRR=0.53，P<0.05，CI=0.32-0.88）有关。控制行为与贫血（调整后的 RRR=1.31，P<0.01，CI=1.11-1.54）有关。
在尼泊尔已婚妇女中，身体暴力似乎是体重的一个危险因素，而控制行为是贫血状况的一个危险因素。需要进行更多严格的混合方法研究，以了解在尼泊尔和其他环境中 IPV 报告以及 IPV 经历与营养之间存在或不存在的关系。
