Intimate partner violence and late entry into antenatal care in Ethiopia

Gashaw, Bosena Tebeje; Magnus, Jeanette H.; Schei, Berit

doi:10.1016/j.wombi.2018.12.008

Cited by 33 publications

(32 citation statements)

References 44 publications

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“…For instance, women who are psychologically abused can be at a greater risk of postnatal depression, are more likely to think about harming themselves and their infants [46,47], while emotional IPV is linked with preeclampsia [26,48] and hypertension [26]. In line with the reflections of the HCWs in our study, prior studies have documented the effect IPV has on maternal health service utilization [22,49,50], illustrating that the impacts of IPV in pregnancy is multifaceted [42,51].…”

Section: Discussionsupporting

confidence: 81%

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Ethiopian Health Care Workers’ Insights into and Responses to Intimate Partner Violence in Pregnancy—A Qualitative Study

Gashaw

Schei

Solbrække

et al. 2020

IJERPH

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Violence against women is a global pandemic, with the potential to spread through generations. Intimate partner violence has impacts on women’s sexual, reproductive, and psycho-social health. It can occur during pregnancy and adversely affect the health of both mother and child. Health care workers involved in antenatal care can have a unique role in identifying intimate partner violence and in intervening, preventing, and mitigating its consequences. In this study, the objective was to explore Ethiopian health care workers’ insights of and responses to intimate partner violence in pregnancy. Using an exploratory design, this qualitative study includes ten semi-structured interviews of health care workers representing different antenatal care centers in Jimma, Ethiopia. The content analyses of translated interview notes were conducted with Atlas.ti7 software, (Atlas.ti Scientific Software Development Gmbh, Berlin). The health care workers shared their insights of the consequences of intimate partner violence during pregnancy in addition to their experience with and responses to the victims. There was a limited understanding of the extent of the adverse impacts of intimate partner violence on pregnancy outcomes, as well as the potential long-term health implications. The informants described how they only gave medical treatment for obstetric complications or visible trauma during pregnancy. There was no formal referral to or linkages with other resources. Women’s empowerment and systemic changes in the health care, including training and capacity building, clear guidelines addressing management of intimate partner violence in pregnancy, and inclusion of intimate partner violence screening tools in the Ethiopian antenatal care chart/card, were recommended by the informants. The adverse impacts of intimate partner violence on pregnancy outcomes were poorly understood by the Ethiopian health care workers in this study. They offered limited assistance to the victims and recommended changes in the routine antenatal care (ANC) and health care systems. They identified various policy initiatives focusing on women’s empowerment to reduce intimate partner violence and its complications especially during pregnancy.

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Section: Discussionsupporting

confidence: 81%

“…In Ethiopia, 36% women report IPV in pregnancy, and as many as 81% report lifetime physical or emotional IPV experience [7,22]. IPV screening is not included in ANC services in Ethiopia, where 74% of the pregnant women have at least one ANC visit [23].…”

Section: Introductionmentioning

confidence: 99%

Ethiopian Health Care Workers’ Insights into and Responses to Intimate Partner Violence in Pregnancy—A Qualitative Study

Gashaw

Schei

Solbrække

et al. 2020

IJERPH

Self Cite

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“…Participants regarded IPV in pregnancy as affecting both the mother and foetus in general terms, stating that mainly physical violence had adverse outcomes on pregnancy. Many studies have documented the effects of IPV on maternal health service utilization [24,45,46], and its multifaceted effect on maternal and neonatal outcomes [47,48]. It is also worth noting that not only physical but also other types of IPV in pregnancy can adversely affect maternal and foetal wellbeing.…”

Section: Discussionmentioning

confidence: 99%

Community Stakeholders’ Perspectives on Intimate Partner Violence during Pregnancy—A Qualitative Study from Ethiopia

Gashaw

Magnus

Scheib

et al. 2019

IJERPH

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Intimate partner violence (IPV) in pregnancy adversely affects the health of women and unborn children. To prevent this, the community responses, societal systems, and structures to support victims of IPV in pregnancy are vital. Objectives: to explore community stakeholders’ perspectives related to IPV in pregnancy in Jimma, Ethiopia, and if needed, create the knowledge base for interventions. Methods: using an exploratory design, this qualitative study had a maximum-variation (multiple spectrum sources) sampling strategy with 16 semi-structured interviews of purposively selected key informants representing different community institutions. Guided by Connell’s theory of gender and power, a content analysis of the translated interviews was conducted using Atlas.ti 7 software. Results: reconciliation between IPV victims and their abusers was the solution promoted by almost all the respondents. There was limited awareness of the adverse impacts IPV in pregnancy has on the health of the woman and the foetus. Despite regular encounters with victims, there is no organized or structured operational response to support IPV victims between the participating institutions. Conclusion: the potential danger of IPV for the mother or the unborn child was not well understood by the members of the studied Ethiopian community. Neither coordinated efforts to support IPV victims nor links among relevant agencies existed. The study demonstrated the dire need of coordinated practical action, changes in current socio-cultural norms, formal training and capacity building, awareness creation, clear intervention guidelines, and facilitation of support networks among relevant institutions in Ethiopian communities.

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“…(28,29) The AAS has a simple scoring system and has been validated in perinatal settings. (30)(31)(32)(33)(34)(35)(36) It is a ve item questionnaire that has demonstrated a large range of prevalence from 2.8% (34) to 35.5% (35) for IPV during the antenatal period and up to 41% (31) for any history of IPV among a sample of pregnant women. Further, all three of these scales (i.e., WAST, AAS, HARK) do not capture coercive control which is seen as an important part of the pattern of IPV.…”

Section: Introductionmentioning

confidence: 99%

Validity of the ACTS Intimate Partner Violence Screen in Antenatal Care: A Cross Sectional Study

Hegarty

Spangaro

Kyei-Onanjiri

et al. 2021

Preprint

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Background: Intimate partner violence (IPV) is a major public health problem with harmful consequences. In Australia, there is no national standard screening tool and screening practice is variable across states. The objectives of this study were to assess in the antenatal healthcare setting: i) the validity of a new IPV brief screening tool and ii) women’s preference for screening response format, screening frequency and comfort level.Methods: 1,067 antenatal patients in a major metropolitan Victorian hospital in Australia completed a paper-based, self-administered survey. The survey included four screening items about whether they were Afraid/Controlled/Threatened/ Slapped or physically hurt (ACTS) by a partner or ex-partner in the last 12 months; and the Composite Abuse Scale (reference standard). The ACTS screen was presented firstly with a binary yes/no response format and then with a five-point ordinal frequency format from ‘never’ (0) to ‘very frequently’ (4). The main outcome measures were test statistics of the four-item ACTS screening tool (sensitivity, specificity, predictive values, and area under the curve) against the reference standard and women’s screening preferences.Results: Twelve-month IPV prevalence varied depending on the ACTS response format with 8% (83) positive on ACTS yes/no format, 12.8% (133) positive on ACTS ordinal frequency format and 10.5% (108) on the reference Composite Abuse Scale. Overall, the ACTS screening tool demonstrated clinical utility for the ordinal frequency format (AUC, 0.80; 95% CI = 0.76 to 0.85) and the binary yes/no format (AUC, 0.74, 95% CI = 0.69 to 0.79). The frequency scale (66%) had greater sensitivity than the yes/no scale (51%). The positive and negative predictive values were 56% and 96% for the frequency scale and 68% and 95% for the yes/no scale. Specificity was high regardless of screening question response options. Half (53%) of the women categorised as abused preferred the yes/no scale. Around half of the women (48%, 472) thought health care providers should ask pregnant women about IPV at every visit.Conclusions: The four-item ACTS tool (using the frequency scale and a cut-off of one on any item) is recommended for written self-administered screening of women to identify those experiencing IPV to enable first-line response and follow-up.

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Intimate partner violence and late entry into antenatal care in Ethiopia

Cited by 33 publications

References 44 publications

Ethiopian Health Care Workers’ Insights into and Responses to Intimate Partner Violence in Pregnancy—A Qualitative Study

Ethiopian Health Care Workers’ Insights into and Responses to Intimate Partner Violence in Pregnancy—A Qualitative Study

Community Stakeholders’ Perspectives on Intimate Partner Violence during Pregnancy—A Qualitative Study from Ethiopia

Validity of the ACTS Intimate Partner Violence Screen in Antenatal Care: A Cross Sectional Study

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