Luhumyo Loice, Mwaliko Emily, Tonui Philliph, Getanda Amos, Hann Katrina
Consultant Obstetrician Gynaecologist, Uasin Gishu County, Kenya.
Department of Reproductive Health, Moi University, Box 4606, Eldoret, Kenya.
Health Policy Plan. 2020 Nov 1;35(Supplement_1):i7-i18. doi: 10.1093/heapol/czaa103.
Intimate partner violence (IPV) is sexual, psychological and physical coercive acts used against persons by intimate partners. When IPV occurs during pregnancy (IPVp), it can result in adverse maternal and pregnancy outcomes. No policy nor practice direction exists to address the rates and risk factors of IPVp in Kenya. Determining the prevalence, types and determinants of IPVp in Western Kenya would aid in the identification of pregnant women affected by and/or at risk of IPVp, as well as informing the development of policy, practices and programmes to support preventive interventions. In this cross-sectional study of 369 women who had given birth at Moi Teaching and Referral Hospital, participants were recruited using systematic sampling and data collected via structured questionnaires adopted from the WHO Violence Against Women Instrument. Associations were made in relation to physical or sexual violence and psychological violence. Logistic regression was used to assess the association between determinants and occurrence of IPVp. The overall prevalence of IPVp was 34.1%. Prevalence of physical or sexual violence was 22.8%. Psychological violence emerged as the most common (27.4%) form of IPVp. A lower than tertiary level of education and previous experience of IPV were individually associated with physical/sexual IPVp, whereas psychological IPVp was associated with previous experience of IPV and was prevented by the intimate partner having formal employment. Preterm birth rates were found to be higher than the country's rates. The prevalence rates of IPVp are high in Western Kenya. Strategies that address the promotion of respectful, nonviolent relationships and that interrupt the development of risk factors are required. Policies (clinical guidelines) targeting prevention of IPVp and screening and the identification of at-risk women and survivors of IPVp are needed urgently. Primary prevention through interrupting the occurrence of predisposing factors is key in addressing IPVp.
亲密伴侣暴力（IPV）是亲密伴侣对他人实施的性、心理和身体上的胁迫行为。当亲密伴侣暴力发生在孕期（IPVp）时，可能会导致不良的孕产妇和妊娠结局。肯尼亚没有相关政策或实践指南来应对IPVp的发生率及风险因素。确定肯尼亚西部IPVp的患病率、类型和决定因素，将有助于识别受IPVp影响和/或有IPVp风险的孕妇，并为制定支持预防性干预措施的政策、实践和项目提供信息。在这项对369名在莫伊教学与转诊医院分娩的妇女进行的横断面研究中，采用系统抽样方法招募参与者，并通过采用世界卫生组织《暴力侵害妇女行为调查问卷》中的结构化问卷收集数据。对身体暴力或性暴力与心理暴力进行了关联分析。采用逻辑回归评估决定因素与IPVp发生之间的关联。IPVp的总体患病率为34.1%。身体暴力或性暴力的患病率为22.8%。心理暴力是IPVp最常见的形式（27.4%）。受教育程度低于大专水平以及既往有亲密伴侣暴力经历分别与身体/性IPVp相关，而心理IPVp与既往亲密伴侣暴力经历相关，且亲密伴侣有正式工作可预防心理IPVp。研究发现早产率高于该国平均水平。肯尼亚西部IPVp的患病率很高。需要采取策略促进建立相互尊重、非暴力的关系，并阻断风险因素的形成。迫切需要制定针对预防IPVp以及筛查和识别有风险妇女及IPVp幸存者的政策（临床指南）。通过阻断诱发因素发生进行一级预防是应对IPVp问题的关键。
