Effect of maternal exposure to intimate partner violence on under-five mortality in Nigeria

Abstract

Background:The under-5 mortality rate in many developing countries has shown little or no improvement over the years. Ravaged by war and poverty, violence which is now a norm in most African countries (including Nigeria) is on the increase and has condensed into most families with women and children bearing the major brunt of this violence. Aim: Effect of maternal exposure to intimate partner violence on under-5 mortality in Nigeria. Methods: Data from nationally representative sample of mothers (aged 15-49 years) was obtained from the 2008 Nigeria Demoraphic and Health Survey. Cox regression and multiple logistic regressions were used to identify and examine the association between maternal exposure to intimate partner violence and under-5 death and use of maternal and child health services after controlling for potential confounding factors. Results: The prevalence of intimate partner violence (IPV) in Nigeria is 34.9%. This may be lower than the actual prevalence due to under reporting of cases of IPV in most developing countries. Women not exposed to intimate partner violence were 0.77 times less likely to lose a child under-5 compared to women exposed to intimate partner violence (HR=0.77 95%CI 0.64-0.81). Decision making autonomy in family activities significantly affected loss of a child under-5 in the face of IPV. Similarly women not exposed to IPV were 1.74 times more likely to use maternal and child health services compared to exposed mothers (OR=1.74 95% CI 1.65-1.83). Age of mother, educational status of mothers, social class, occupation, marital status, access to media and decision making autonomy were retained as important maternal predictors of use of maternal and child health services when exposed to IPV in multivariate analysis (p<0.05). Conclusion: Intimate Partner Violence has a significant effect on under-5 mortality. Therefore tackling this social menace will not only reduce the effect on child mortality but also address the ill societal effect that results from family collapse following IPV.

Intimate Partner Violence and the Utilization of Maternal Health Care Services in Nigeria

“…This finding is consistent with the lifetime prevalence of IPV in sub-Saharan Africa and Nigeria (Jewkes et al, 2002;Osuora et al, 2012). The high prevalence of IPV found in this study could suggest the patriarchal ideology in traditional societies such as Nigeria where gender roles are being skewed to justify violence against women who are assigned an inferior role to men (Antai, 2011).…”

“…Furthermore, Emenike and colleagues (2008) found a significant association between physical/emotional/sexual abuse of women and negative reproductive health outcomes such as terminated pregnancies and infant mortality. In Nigeria, women's exposure to IPV was associated with low use of contraception, miscarriages, induced abortion, and child mortality (Okenwa, Lawoko, & Jansson, 2011;Osuora et al, 2012). Antai (2011) found a strong association between IPV and traumatic physical consequences.…”

“…Researchers in Nigeria found an IPV prevalence rate ranging between 17% and 34% (Antai, 2011;Osuora, Omolo, Kamweya, Harder, & Mutai, 2012). The huge range of IPV prevalence estimates is assumed to be related to the acceptance of IPV as a justifiable punishment and societal norm in many parts of Africa (Osuora et al, 2012).…”

Maternal Employment and Child Survival During the Era of Sustainable Development Goals: Insights from Proportional Hazards Modelling of Nigeria Birth History Data

“…Regional differences in childhood mortality have been linked to variations in the socio-economic characteristics and utilisation of maternal and child health care services [212223]. Studies that focussed on the relationship between maternal employment and childhood mortality are rare, though a few included maternal employment as a control variable [242526].…”

Single motherhood and neonatal and infant mortality in Sierra Leone, Burkina Faso and Burundi

“…1 Some other researchers examined the interaction between intimate partner violence and childhood mortality. 24 In such studies, 25 it was observed that infant and neonatal mortality was greater among children whose mothers experienced intimate partner violence versus those whose mothers did not experience intimate partner violence. The primary explanation of the influence of violence against women on the risk of neonatal and infant mortality is the possible constraining effect of such violence upon women's ability to physically and emotionally care and provide for their children's basic needs.…”