Aboagye Richard Gyan, Seidu Abdul-Aziz, Asare Bernard Yeboah-Asiamah, Adu Collins, Ahinkorah Bright Opoku
Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.
Arch Public Health. 2022 Apr 20;80(1):124. doi: 10.1186/s13690-022-00853-y.
Intimate partner violence (IPV) during pregnancy has negative physical and psychological health consequences on the pregnant women. As such, women who experience IPV during pregnancy are likely to have challenges accessing maternal healthcare services. In this study, we examined the influence of exposure to IPV on timely antenatal care (ANC) visits in sub-Saharan Africa.
Cross-sectional data from the most recent Demographic and Health Survey of twenty-two countries in sub-Saharan Africa between 2012 and 2020 were analysed. Data were obtained from 61,282 women with birth history in the five years prior to the survey. A multilevel logistic regression was used to determine the association between IPV and timely ANC visits while controlling for significant covariates. Adjusted odds ratios (aOR) with 95% Confidence Intervals (CI) were used to present results from the multilevel logistic regression analysis.
The prevalence of timely ANC visit and IPV were 38.1% and 34.9% respectively. The highest and lowest prevalence of IPV were found in Sierra Leone (52.9%) and Comoros (8.1%), respectively. Timely ANC attendance among pregnant women was more prevalent in Liberia (74.9%) and lowest in DR Congo (19.0%). Women who experienced IPV during pregnancy were less likely to utilize timely ANC (aOR = 0.89, 95% CI = 0.86-0.92) compared to those who did not experience IPV. In terms of the covariates, the odds of timely ANC were higher among women aged 40-44 compared to those aged 15-19 (aOR = 1.35, 95% CI = 1.21-1.51). Higher odds of timely ANC was found among women who were cohabiting (aOR = 1.15, 95% CI = 1.10-1.20), those from the richest wealth quintile (aOR = 1.38, 95% CI = 1.28-1.48), those exposed to watching television (aOR = 1.24, 95% CI = 1.18-1.30), and those with health insurance (aOR = 1.46, 95% CI = 1.37-1.56).
Findings from the study indicate the role of IPV in timely ANC visit in sub-Saharan Africa. To enhance timely ANC visits, there is the need for policy makers to strengthen and enforce the implementation of policies that alleviate IPV during pregnancy. Education and sensitization of married and cohabiting women and men on the negative effects of IPV on timely ANC should be done using media sources such as television. Inequalities in timely ANC can be eliminated through the provision and strengthening of existing maternal health policies such as health insurance.
孕期亲密伴侣暴力（IPV）会对孕妇的身心健康产生负面影响。因此，孕期遭受亲密伴侣暴力的女性在获得孕产妇保健服务方面可能会面临挑战。在本研究中，我们考察了在撒哈拉以南非洲地区，遭受亲密伴侣暴力对及时进行产前检查（ANC）的影响。
分析了2012年至2020年间撒哈拉以南非洲22个国家最近一次人口与健康调查的横断面数据。数据来自调查前五年内有生育史的61282名女性。在控制显著协变量的同时，使用多水平逻辑回归来确定亲密伴侣暴力与及时进行产前检查之间的关联。多水平逻辑回归分析的结果采用调整后的比值比（aOR）和95%置信区间（CI）来呈现。
及时进行产前检查和亲密伴侣暴力的患病率分别为38.1%和34.9%。亲密伴侣暴力患病率最高和最低的分别是塞拉利昂（52.9%）和科摩罗（8.1%）。孕妇及时进行产前检查的情况在利比里亚最为普遍（74.9%），在刚果民主共和国最低（19.0%）。与未遭受亲密伴侣暴力的女性相比，孕期遭受亲密伴侣暴力的女性不太可能及时进行产前检查（aOR = 0.89，95% CI = 0.86 - 0.92）。在协变量方面，40 - 44岁女性及时进行产前检查的几率高于15 - 19岁的女性（aOR = 1.35，95% CI = 1.21 - 1.51）。同居女性（aOR = 1.15，95% CI = 1.10 - 1.20）、最富有财富五分位数组的女性（aOR = 1.38，95% CI = 1.28 - 1.48）、经常看电视的女性（aOR = 1.24，95% CI = 1.18 - 1.30）以及有医疗保险的女性（aOR = 1.46，95% CI = 1.37 - 1.56）及时进行产前检查的几率更高。
该研究结果表明了亲密伴侣暴力在撒哈拉以南非洲地区及时进行产前检查方面所起的作用。为了增加及时进行产前检查的比例，政策制定者需要加强并实施减轻孕期亲密伴侣暴力的政策。应利用电视等媒体资源，对已婚和同居的女性及男性进行关于亲密伴侣暴力对及时进行产前检查的负面影响的教育和宣传。可以通过提供并加强现有的孕产妇健康政策，如医疗保险，来消除及时进行产前检查方面的不平等现象。
