Agde Zeleke Dutamo, Magnus Jeanette H, Assefa Nega, Wordofa Muluemebet Abera
Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia.
Department of Reproductive Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia.
PLoS One. 2025 Jan 17;20(1):e0317667. doi: 10.1371/journal.pone.0317667. eCollection 2025.
Pregnancy is often seen as a joyful and fulfilling time for many women. However, a significant number of women in Ethiopia experience intimate partner violence (IPV) during this period. Despite this, there is limited evidence on interventions aimed at preventing violence during pregnancy. The purpose of this trial was to examine the effectiveness of Couple-Based Violence Prevention Education (CBVPE) in reducing IPV during pregnancy in rural Ethiopia.
A cluster randomized controlled trial was conducted using a two-arm parallel group design. The 16 clusters were randomly allocated into 8 intervention groups and 8 control groups. A total of 432 pregnant women (216 in the intervention group and 216 in the control group) participated in the trial. Couple-based violence prevention education was provided to the participants in the intervention group, while the control group received routine or standard care. We used difference-in-difference analysis and the Generalized Estimating Equation (GEE) model to assess the effectiveness of the intervention.
At the endline, 94.9% of women in the intervention group and 95.3% of women in the control group were available for intention-to-treat analysis. There was a substantial drop in the proportion of any IPV during pregnancy from 39.4% at baseline to 13.0% at endline (p<0.001). Women in the intervention group were 74.1% less likely to report any IPV during pregnancy compared to the control group (AOR = 0.259; 95% CI 0.161-0.417). Specifically, the intervention also reduced psychological, physical, and sexual violence during pregnancy.
The study found that CBVPE is effective in reducing IPV during pregnancy in the study setting. Scale-up and adaptation to similar settings are recommended.
The trial is registered on ClinicalTrials.gov under the identifier NCT05856214 on May 4, 2023.
对许多女性来说，怀孕通常被视为一段快乐且充实的时光。然而，埃塞俄比亚有相当数量的女性在孕期遭受亲密伴侣暴力（IPV）。尽管如此，针对预防孕期暴力的干预措施的证据有限。本试验的目的是检验基于夫妻的暴力预防教育（CBVPE）在减少埃塞俄比亚农村地区孕期亲密伴侣暴力方面的有效性。
采用双臂平行组设计进行整群随机对照试验。16个整群被随机分为8个干预组和8个对照组。共有432名孕妇（干预组216名，对照组216名）参与了试验。干预组的参与者接受了基于夫妻的暴力预防教育，而对照组接受常规或标准护理。我们使用差分分析和广义估计方程（GEE）模型来评估干预措施的有效性。
在终期，干预组94.9%的女性和对照组95.3%的女性可用于意向性分析。孕期任何形式亲密伴侣暴力的比例从基线时的39.4%大幅降至终期时的13.0%（p<0.001）。与对照组相比，干预组的女性在孕期报告任何亲密伴侣暴力的可能性降低了74.1%（调整后的比值比=0.259；95%置信区间0.161 - 0.417）。具体而言，该干预措施还减少了孕期的心理、身体和性暴力。
研究发现，在本研究环境中，基于夫妻的暴力预防教育在减少孕期亲密伴侣暴力方面是有效的。建议扩大规模并应用于类似环境。
该试验于2023年5月4日在ClinicalTrials.gov上注册，标识符为NCT05856214。
