School of Nursing, University of Michigan, Ann Arbor, MI, USA.
Learning Health Sciences, University of Michigan, Ann Arbor, MI, USA.
Glob Health Action. 2024 Dec 31;17(1):2325250. doi: 10.1080/16549716.2024.2325250. Epub 2024 Apr 5.
Intimate partner violence (IPV) impacts women of reproductive age globally and can lead to significant negative consequences during pregnancy. This study describes an exploratory aim of a cluster randomised controlled trial designed to assess the outcomes of Group Antenatal Care (ANC) in Ghana. The purpose was to understand the effect of a healthy relationship Group ANC module on experiences of IPV and safety planning as well as to explore the relationship between self-efficacy on the experiences of IPV and safety planning. Data were collected at baseline and at 11-14 months postpartum (post). Survey measures captured reported experiences of violence, self-efficacy, and safety. The chi-square test was used to compare baseline and post scores, and a logistic regression was performed to ascertain the effects of self-efficacy on the experiences of IPV in both groups. The sample included 1,751 participants, of whom 27.9% reported IPV at baseline. Between baseline and postpartum, there was a small increase in reported emotional (6.2% vs. 4.6%) and sexual (5.4% vs. 3.2%) violence in the intervention group compared to the control group. Logistic regression demonstrated that an increasing self-efficacy score was associated with an increased likelihood of experiencing IPV. There were no changes in safety knowledge. This study found higher rates of reported sexual and emotional violence post-intervention among the intervention group. Group ANC may be just one part of a portfolio of interventions needed to address IPV at all socio-ecological levels.Paper Context There was no reduction in experiences of intimate partner violence or increases in safety planning among Ghanaian pregnant women participating in a Group Antenatal Care session focused on healthy relationships and safety planning. Group Antenatal Care has been identified as an effective modality for providing antenatal care and facilitating conversations about sensitive topics such as intimate partner violence and safety. However, this study highlights the importance of developing multifaceted approaches to decrease the risk of intimate partner violence among women, especially during the critical times of pregnancy and postpartum. Effective global health action and policy must extend beyond educational efforts, incorporating multifaceted strategies that include healthcare provider training, robust community engagement, and legislation aimed at preventing intimate partner violence, with a special focus on safeguarding the well-being of women during pregnancy and the postpartum period.
亲密伴侣暴力（IPV）在全球范围内影响育龄妇女，并可能在怀孕期间导致严重的负面后果。本研究描述了一项集群随机对照试验的探索性目标，旨在评估加纳群体产前护理（ANC）的结果。目的是了解健康关系组 ANC 模块对 IPV 和安全规划体验的影响，并探讨自我效能感与 IPV 和安全规划体验之间的关系。数据在基线和产后 11-14 个月（产后）收集。调查措施包括报告的暴力、自我效能和安全经验。卡方检验用于比较基线和产后得分，逻辑回归用于确定自我效能感对两组 IPV 体验的影响。样本包括 1751 名参与者，其中 27.9%在基线时报告了 IPV。在基线和产后期间，干预组报告的情绪暴力（6.2%对 4.6%）和性暴力（5.4%对 3.2%）略有增加，而对照组则有所减少。逻辑回归表明，自我效能感得分的增加与经历 IPV 的可能性增加有关。安全知识没有变化。本研究发现，干预组在干预后报告的性暴力和情绪暴力发生率更高。群体 ANC 可能只是解决所有社会生态层面上 IPV 问题所需的一系列干预措施的一部分。
在加纳，参与关注健康关系和安全规划的群体产前护理会议的孕妇，其亲密伴侣暴力或安全规划的经历并没有减少。群体产前护理已被确定为提供产前护理和促进关于亲密伴侣暴力和安全等敏感话题的对话的有效模式。然而，本研究强调了制定多方面方法的重要性，以降低妇女，特别是在怀孕和产后关键时期，亲密伴侣暴力的风险。有效的全球卫生行动和政策必须超越教育努力，包括多方面的战略，包括医疗保健提供者培训、强大的社区参与和旨在预防亲密伴侣暴力的立法，特别关注保护妇女在怀孕和产后期间的福祉。
