Maternal experiences of multiple forms of intimate partner violence and associations with undernutrition among children under 5: evidence from 36 low- and middle-income countries based on demographic and health surveys.

BACKGROUND

Intimate partner violence (IPV) is a global issue and has various negative impacts on women and their children's physical and psychological health. Although the co-occurrence of multiple forms of IPV (ie, physical, psychological and sexual IPV) against women is prevailing, its negative effects on their children's nutrition remain neglected. This study aimed to explore such effects among children under 5.

METHODS

We used a sample of 104 740 mother-child pairs from 36 low- and middle-income countries based on the Demographic and Health Surveys between 2005 and 2022. Pooled and income level-specific survey logistic regressions were performed to assess the associations between maternal experience of any form of IPV, multiple forms of any IPV, co-occurrence of different forms of IPV and number of IPV forms within the past 12 months, with child undernutrition.

FINDINGS

Maternal exposure to multiple forms of IPV was significantly associated with an increased risk of child wasting (OR: 1·2, 95% CI: 1·0 to 1·4) and underweight (OR: 1·2, 95% CI: 1·1 to 1·4), while no significant association was found for stunting. Significant dose-response effects of the number of IPV forms were found for child wasting (p<0·05) and underweight (p<0·05). The co-occurrence of psychological and sexual IPV showed the most significant impact on child wasting (OR: 1·4, 95% CI: 1·2 to 1·8) across subtypes of co-occurrence. Most significant results were detected in lower- and middle-income countries. Children whose mothers were shorter than average, underweight, lived in rural areas and poorer families were more vulnerable to undernutrition.

INTERPRETATION

This study highlighted the negative effect of multiple forms of maternal IPV on child wasting and underweight with a focus on the number of IPV experienced. Our findings called for enhanced policy-based efforts to end gender-based violence to protect the health and rights of both women and children.

FUNDING

This research is supported by the National Natural Science Foundation of China (No. 72074130).