Domestic violence and food insecurity among pregnant women in Nepal: a cross-sectional study.

BACKGROUND

Domestic violence and food insecurity are significant global health challenges, particularly during pregnancy, when both can adversely affect maternal and child health. Food insecurity may occur independently or as a consequence of domestic violence, yet their relationship remains underexplored. This study aims to investigate the association between exposure to domestic violence perpetrated by intimate partners or by family members and food insecurity during pregnancy.

METHODS

This cross-sectional study used baseline data from 2129 pregnant women attending routine antenatal care as part of an ongoing randomized controlled trial. Inclusion criteria were age ≥ 18 years, gestational age between 12 and 22 weeks, and consent to participate. Colour-Coded Audio Computer-Assisted Self-Interview method was administered via a computer tablet for data collection. Domestic violence was assessed using the Nepalese Abuse Assessment Screen and food insecurity using a modified Household Food Insecurity Access Scale.

RESULTS

Of the participants, 12.9% reported food insecurity, and 6% reported experiencing some form of DV. Women reporting any domestic violence, domestic violence perpetrated by intimate partners only or by family members only had significantly higher odds of food insecurity after adjusting for socio-demographic, economic and obstetric factors [Adjusted Odds Ratio (95% CI): 2.5 (1.6-3.9), 3.3 (1.5-7.5) and 2.1 (1.2-3.5) respectively].

CONCLUSIONS

Domestic violence was strongly associated with food insecurity during pregnancy. Screening for domestic violence among food-insecure pregnant women and addressing underlying causes could mitigate risks to maternal and child health.