Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia.
PLoS One. 2024 Jul 11;19(7):e0304498. doi: 10.1371/journal.pone.0304498. eCollection 2024.
Intimate Partner Violence (IPV) is a major public health problem worldwide. In developing nations, including Ethiopia, the problem is under-reported and under-estimated. Therefore, this study attempts to assess intimate partner violence and its associated factors among pregnant women receiving antenatal care at public hospitals in Amhara region, Ethiopia.
A health facility-based cross-sectional study design was employed. A sample of 418 pregnant women was selected using random sampling technique from 1st May to 1st June 2021. IPV was measured using the World Health Organization (WHO) Multi-country study of violence against women assessment tool. Data were entered into Epi-data 3.1 and exported into Stata 17 for further analysis. A Bayesian multivariable logistic regression analysis was carried out from the posterior distribution, and an adjusted odds ratio (AOR) with a 95% credible interval (CrI) was used to declare statistically significant variables.
The prevalence of any IPV among pregnant women was 31.3% [95% CrI 26.6%, 36.1%]. After adjusting a range of covariates, IPV during pregnancy was more likely among women whose husbands used substances [AOR = 4.33: 95% CrI 1.68, 8.95] and household decisions made by husbands only [AOR = 6.45: 95% CI 3.01, 12.64]. Conversely, pregnant women who attended primary [AOR = 0.47: 95% CrI 0.24, 0.81] and secondary [AOR = 0.64: 95% CrI 0.41, 0.92] educational levels, women who had four or more ANC visits antenatal care visits [AOR = 0.43: 95% CrI 0.25, 0.68], and women with no prior history of adverse birth outcomes [AOR = 0.48: 95% CI 0.27, 0.80] were less likely to experience IPV during pregnancy.
The study revealed a relatively high prevalence of any IPV among pregnant women, with factors such as substance use by husbands and limited decision-making autonomy associated with increased IPV likelihood. Conversely, women with higher education levels, four and above antenatal care attendance, and no history of adverse birth outcomes showed a reduced likelihood of experiencing IPV during pregnancy. Therefore, targeted interventions to address substance use, empower women in decision-making, and promote education and healthcare access to mitigate IPV risk during pregnancy are recommended.
亲密伴侣暴力（IPV）是全球范围内一个重大的公共卫生问题。在发展中国家，包括埃塞俄比亚，该问题的报告和估计都不足。因此，本研究试图评估在埃塞俄比亚阿姆哈拉地区公立医院接受产前护理的孕妇中亲密伴侣暴力及其相关因素。
采用基于卫生机构的横断面研究设计。2021 年 5 月 1 日至 6 月 1 日期间，采用随机抽样技术从 418 名孕妇中抽取样本。使用世界卫生组织（WHO）多国家暴力侵害妇女评估工具测量 IPV。数据输入 Epi-data 3.1 并导出到 Stata 17 进行进一步分析。采用贝叶斯多变量逻辑回归分析从后验分布中进行分析，并使用调整后的优势比（AOR）和 95%可信区间（CrI）来宣布具有统计学意义的变量。
孕妇中任何形式 IPV 的患病率为 31.3%[95%CrI 26.6%，36.1%]。调整了一系列协变量后，丈夫使用物质的孕妇发生孕期 IPV 的可能性更高[AOR=4.33：95%CrI 1.68，8.95]，而仅由丈夫做出家庭决策的孕妇发生孕期 IPV 的可能性更高[AOR=6.45：95%CI 3.01，12.64]。相反，接受过小学[AOR=0.47：95%CrI 0.24，0.81]和中学[AOR=0.64：95%CrI 0.41，0.92]教育程度的孕妇、进行了 4 次或更多次产前护理就诊的孕妇[AOR=0.43：95%CrI 0.25，0.68]，以及没有不良生育结局既往史的孕妇[AOR=0.48：95%CI 0.27，0.80]发生孕期 IPV 的可能性较低。
本研究显示，孕妇中 IPV 的患病率相对较高，丈夫使用物质和决策自主权有限等因素与 IPV 发生的可能性增加相关。相反，教育程度较高、接受了 4 次或以上产前护理就诊和没有不良生育结局既往史的孕妇发生孕期 IPV 的可能性较低。因此，建议针对孕妇实施有针对性的干预措施，包括解决物质使用问题、增强妇女在决策中的自主权，以及促进教育和医疗保健的获取，以降低孕期 IPV 的风险。
