Muluneh Muluken Dessalegn, Francis Lyn, Agho Kingsley, Stulz Virginia
Amref Health Africa in Ethiopia, Addis Ababa, Ethiopia.
Western Sydney University, Parramatta South Campus.
J Interpers Violence. 2023 Apr;38(7-8):5375-5403. doi: 10.1177/08862605221120894. Epub 2022 Sep 8.
Intimate partner violence (IPV) adversely affects female reproductive health in various ways. Similarly, it plays a critical role in women's unintended pregnancy. This study examines the relationship between IPV and unintended pregnancy in Eastern Sub-Saharan Africa (SSA) countries. This study uses data from the nationally representative Demographic and Health Surveys (DHS) in six Eastern African SSA countries. The original sample size was restricted to ever married (or cohabitating) women of reproductive age who completed the survey's Domestic Violence Module and had a pregnancy in the previous 5 years. Svyset proportion was used to estimate the prevalence and 95% confidence intervals (CI) of the study outcomes and multiple logistic regression was used to compare outcomes of last pregnancy by exposure to lifetime IPV committed by the most recent partner. The prevalence of unintended pregnancy in Eastern SSA was 38% [36.4, 40.34] among married women with high disparity among countries. This prevalence was 45% [42.05, 48.15] and 55% [50.0, 59.87] among women who had experienced any form of IPV and sexual violence, respectively. After adjusting for potential confounding factors, women with a history of sexual violence had a higher risk of unintended pregnancy [AOR: 1.80, 95% CI: 1.39, 2.33] and increased odds of unintended pregnancy for women who had more than five living children [AOR: 4.93, 95% CI: 3.40, 7.15], women who lived in rural residences [AOR: 1.42, 95% CI: 1.07, 1.90], and women who reported they had financial barriers for health care [AOR: 1.36, 95% CI: 1.13, 1.64]. Our findings suggest that IPV, particularly sexual violence, is a key player for higher risk of unintended pregnancy in Eastern SSA countries. This study highlights the need for developing programs and implementation of policies that integrate sexual reproductive health and IPV to reduce unintended pregnancy among married and single women.
亲密伴侣暴力（IPV）以多种方式对女性生殖健康产生不利影响。同样，它在女性意外怀孕中也起着关键作用。本研究考察了撒哈拉以南非洲东部（SSA）国家中亲密伴侣暴力与意外怀孕之间的关系。本研究使用了来自六个东非SSA国家具有全国代表性的人口与健康调查（DHS）的数据。原始样本仅限于完成了调查中家庭暴力模块且在过去5年中有过怀孕经历的已婚（或同居）育龄妇女。使用Svyset比例来估计研究结果的患病率和95%置信区间（CI），并使用多元逻辑回归来比较最近伴侣实施的终身亲密伴侣暴力暴露情况下最后一次怀孕的结果。东非SSA地区已婚妇女意外怀孕的患病率为38%[36.4, 40.34]，各国之间差异很大。在经历过任何形式的亲密伴侣暴力和性暴力的女性中，这一患病率分别为45%[42.05, 48.15]和55%[50.0, 59.87]。在调整了潜在的混杂因素后，有性暴力史的女性意外怀孕风险更高[AOR：1.80，95%CI：1.39, 2.33]，对于有五个以上在世子女的女性[AOR：4.93，95%CI：3.40, 7.15]、居住在农村的女性[AOR：1.42，95%CI：1.07, 1.90]以及报告存在医疗保健经济障碍的女性[AOR：1.36，95%CI：1.13, 1.64]，意外怀孕的几率也增加。我们的研究结果表明，亲密伴侣暴力，尤其是性暴力，是东非SSA国家意外怀孕风险较高的一个关键因素。本研究强调了制定将性生殖健康与亲密伴侣暴力相结合的项目并实施相关政策以减少已婚和单身女性意外怀孕的必要性。
