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基于近期人口与健康调查数据的撒哈拉以南非洲国家女性亲密伴侣控制行为的程度及决定因素:一项多层次分析

Magnitude and determinants of intimate partner controlling behavior among women in sub-Saharan African countries from the recent demographic and health survey data: a multilevel analysis.

作者信息

Andualem Fantahun, Nakie Girum, Rtbey Gidey, Melkam Mamaru, Tinsae Techilo, Kibralew Getasew, Mengistie Berihun Agegn, Tadesse Gebresilassie, Gedef Getachew Muluye, Fentahun Setegn

机构信息

Department of Psychiatry, College of Medicine and Health Science, University of Gondar, PO Box 196, Gondar, Ethiopia.

Department of Psychiatry, College of Medicine and Health Science, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Public Health. 2025 May 15;25(1):1787. doi: 10.1186/s12889-025-23004-8.

Abstract

BACKGROUND

Intimate Partner Violence (IPV) is a major public health issue affecting physical, mental, and social well-being, particularly among women. In sub-Saharan Africa (SSA), IPV is widespread, with controlling behaviors being a common form. These behaviors include monitoring movements, social isolation, financial restrictions, and dictating daily choices. Data from Demographic and Health Surveys (DHS) highlight significant variations in these behaviors across countries and communities. Understanding the determinants of intimate partner controlling behavior (IPCB) requires a multi-level approach, considering individual, relational, community, and societal factors. IPCB has far-reaching consequences, impacting victims, families, and communities. This study aims to assess the magnitude and determinants of IPCB among reproductive-age women in SSA.

METHODS

This study is a secondary data analysis based on the DHS conducted in eight Sub-Saharan African countries between 2021 and 2024. The study utilized the women's data-women recode component (IR file) from the most recent DHS 8 datasets with the final weighted sample size 45,839 women. Multilevel logistic regression was conducted to assess factors associated with IPCB. All variables with a p-value < 0.05 were considered statistically significant.

RESULTS

The prevalence of IPCB among reproductive age women in 8 sub-Saharan African countries was 54.47%, with a 95% CI of 54.02-54.93%. This study identified variables of age, marital status; education level, employment status, reproductive health factors, smoking habits, asset ownership, wealth index, residence, and mass media exposure were significantly associated with IPCB.

CONCLUSION

This study highlights a high prevalence of IPCB among reproductive-age women in eight Sub-Saharan African countries, with over half of the women reporting experiences of partner control. These findings suggest the presence of persistent gender power imbalances and socio-cultural norms that may contribute to male dominance in intimate relationships. These associations underscore the importance of promoting women's autonomy and addressing structural gender inequalities. Programs and policies aimed at enhancing women's access to education, economic resources, and information may contribute to reducing IPCB. Community-level interventions that challenge harmful socio-cultural norms and raise awareness through media campaigns could also be beneficial.

摘要

背景

亲密伴侣暴力是一个重大的公共卫生问题,影响着身体、心理和社会福祉,尤其是在女性中。在撒哈拉以南非洲地区,亲密伴侣暴力普遍存在,控制行为是一种常见形式。这些行为包括监视行动、社会隔离、经济限制和支配日常选择。人口与健康调查(DHS)的数据凸显了这些行为在不同国家和社区的显著差异。理解亲密伴侣控制行为(IPCB)的决定因素需要采用多层次方法,考虑个人、关系、社区和社会因素。亲密伴侣控制行为具有深远影响,会对受害者、家庭和社区造成冲击。本研究旨在评估撒哈拉以南非洲地区育龄妇女中亲密伴侣控制行为的程度及其决定因素。

方法

本研究是基于2021年至2024年期间在八个撒哈拉以南非洲国家进行的人口与健康调查的二次数据分析。该研究使用了最新的DHS 8数据集的女性数据——女性重新编码组件(IR文件),最终加权样本量为45,839名女性。进行多水平逻辑回归以评估与亲密伴侣控制行为相关的因素。所有p值<0.05的变量被视为具有统计学意义。

结果

撒哈拉以南非洲8个国家育龄妇女中亲密伴侣控制行为的患病率为54.47%,95%置信区间为54.02 - 54.93%。本研究确定年龄、婚姻状况、教育水平、就业状况、生殖健康因素、吸烟习惯、资产所有权、财富指数、居住地和大众媒体接触等变量与亲密伴侣控制行为显著相关。

结论

本研究凸显了撒哈拉以南非洲8个国家育龄妇女中亲密伴侣控制行为的高患病率,超过半数的妇女报告有伴侣控制的经历。这些发现表明存在持续的性别权力不平衡和社会文化规范,这可能导致男性在亲密关系中占据主导地位。这些关联强调了促进女性自主性和解决结构性性别不平等问题的重要性。旨在增加女性受教育机会、经济资源和信息获取的项目和政策可能有助于减少亲密伴侣控制行为。通过媒体宣传活动挑战有害社会文化规范并提高认识的社区层面干预措施也可能有益。

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